Maternal personality, social support, and changes in depressive, anxiety, and stress symptoms during pregnancy and after delivery: A prospective-longitudinal study

Outcomes of Mothers and Infants Affected by COVID-19

The long-term effects of the novel coronavirus disease 2019 (COVID-19) infection during pregnancy are poorly characterized in mothers and their infants. The aim of this study was to assess the physical, mental, and emotional well-being of mothers and infants in the first year postpartum who were exposed to and/or diagnosed with COVID-19 infection.This direct-to-participant cohort study recruited 96 mother-infant pairs delivering at Pediatrix Medical Group sites, where mothers tested positive for COVID-19 during their pregnancy or birth hospitalization and/or infants tested positive for COVID-19 prior to hospital discharge. Main outcome measures included scored responses to surveys administered at 6 and 12 months postpartum and infant health status from newborn admission through the first year after birth.Mothers with COVID-19 infection during pregnancy often reported persistent physical, mental, and emotional stress affecting both themselves and their infants. Scores assessing infant temperament were higher than reported in prior literature. Infants were relatively healthy throughout their first year after birth.The experience of COVID-19 infection during pregnancy may create a unique set of circumstances that affects the well-being of infants and their mothers separately as well as the child-caregiver relationship. Early life events have the potential to generate lasting consequences; therefore, it is important to identify these issues to maximize support and intervene if indicated. · Experiencing COVID-19 in pregnancy is unique.. · Possible effects on temperament, and relationships.. · This impact may persist for at least 1 year postpartum..

Depressive, anxiety symptoms and their co-occurrence among women seeking antenatal care in Bangladesh

Anxiety and depression are significant concerns among antenatal women in Bangladesh. Despite the critical need for tailored mental health care in health facilities, studies on these symptoms in this demographic remain lacking. Therefore, our study aimed to assess the levels, distribution, and associated factors of depressive and anxiety symptoms and their co-occurrence among women seeking antenatal care at a public healthcare facility in Bangladesh. We conducted a cross-sectional study between May 2024, and June 2024, among women seeking antenatal care (ANC) care in Durgapur Upazila Health Complex, a primary-level public health facility in Bangladesh. Among 640 women who received ANC care, 638 participated in the study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and anxiety symptoms were assessed by the Generalized Anxiety Disorder-7 (GAD-7). Bivariate and multivariable logistic regression were conducted to determine factors contributing to depressive and anxiety symptoms. About 39% of participants had depressive symptoms and 50% had anxiety symptoms, with 26% experiencing both simultaneously. No participants had severe overall depressive or anxiety symptoms. PHQ-9 data indicated half experienced daily fatigue, while GAD-7 data showed over half experienced daily nervousness and two-fifths had daily fears. Women in the second and third trimesters had 43% (aOR: 0.57, 95% CI: 0.36-0.89) and 58% (aOR: 0.42, 95% CI: 0.24-0.71) lower odds of depressive symptoms compared to those in the first trimester respectively. Women with 11 years or more education had 40% (aOR: 0.60, 95% CI: 0.38-0.94) lower odds of anxiety. Additionally, women in the second and third trimesters had 40% (aOR: 0.60, 95% CI: 0.37-0.97) and 49% (aOR: 0.59, 95% CI: 0.29-0.91) lower likelihood of co-occurrence compared to those in the first trimester and women with 6-10 years of education had 48% (aOR: 0.52, 95% CI: 0.34-0.79) and those with 11 or more years had 52% (aOR: 0.48, 95% CI: 0.29-0.81) lower likelihood of co-occurring depressive and anxiety symptoms compared to women with 5 years or less education. Our study found a high prevalence of depressive and anxiety symptoms among antenatal care seekers, with notable co-occurrence of these conditions. Given these findings, there is an urgent need for targeted mental health support for these women, especially those in their first trimester and those with limited education.

Parental relationship satisfaction, symptoms of depression and anger/hostility, and the moderating role of perceived social support-a prospective cohort study in the light of the COVID-19 pandemic

Background

The challenging early parenthood time and the strains of the COVID-19 pandemic negatively affected parental mental health, whereas relationship satisfaction and perceived social support acted protective. Previous research focused on mothers, and little is known about mental health factors besides depression. This study aimed to investigate how relationship satisfaction and perceived social support affected symptoms of depression and anger/hostility in mothers and fathers in the light of the COVID-19 pandemic and whether perceived social support moderated these associations.

Methods

n = 1,414 mothers and n = 885 fathers participating in the prospective cohort DREAM study completed questionnaires 14 months and 2 years postpartum. Hierarchical moderated regression analyses were conducted, controlling for the phase in the COVID-19 pandemic (before, during lockdown, during easements, afterwards) during which mental health was assessed.

Results

Greater relationship satisfaction and perceived social support 14 months postpartum predicted fewer symptoms of depression and anger/hostility 2 years postpartum. Greater perceived social support moderated the association between relationship satisfaction and paternal symptoms of anger/hostility. Mental health symptoms were not significantly associated with the COVID-19 pandemic.

Limitations

Limitations concern the limited representation of the post-pandemic group and the undifferentiated measurement of social support sources.

Conclusion

The importance of relationship satisfaction and perceived social support for parental mental health is highlighted. Perceived social support can enhance the protective effect relationship satisfaction has on paternal symptoms of anger/hostility. Implementing corresponding prevention and education classes could improve parental mental health.

Disgust sensitivity in the first trimester predicts anxiety levels in advanced pregnancy

PROBLEM

Disgust contributes to anxiety-based psychopathology, and in turn, anxiety increases disgust proneness.

BACKGROUND

Disgust and anxiety undergo significant changes in pregnancy, but no previous study has examined their longitudinal associations in this time period.

AIM

This prospective longitudinal study aimed to identify longitudinal associations between disgust sensitivity and state anxiety across the three trimesters of pregnancy, while exploring the directionality of the effect between those two variables.

METHODS

At each trimester of pregnancy, the pregnant women (n = 261) completed the Disgust Scale-Revised (DS-R), the Pathogen disgust domain of the Three Domains of Disgust Scale (TDDS), and the State-Trait Anxiety Inventory. A path analysis (structural equation model) was used to assess cross-lagged effects between disgust sensitivity and state anxiety across the three pregnancy trimesters.

FINDINGS

We found significant cross-lagged associations between disgust and anxiety such that higher disgust (overall DS-R score, Core disgust subscale of DS-R and Pathogen disgust domain of TDDS) in the first trimester predicted greater anxiety in the third. No significant cross-lagged associations were found between Animal-reminder or Contamination disgust subscales of DS-R and state anxiety. State anxiety did not predict disgust sensitivity at any time point.

DISCUSSION

Our results indicate a unidirectional association between disgust sensitivity and state anxiety in pregnant women such that disgust sensitivity in early pregnancy predicts state anxiety in late pregnancy, but anxiety does not predict disgust sensitivity at any time point.

CONCLUSION

Assessing disgust in early pregnancy could help to identify women at risk of higher anxiety levels in advanced pregnancy.

Depression among Latina women in the United States from pregnancy to early postpartum: longitudinal examination of risk factors

BACKGROUND

The present study examined the prevalence of symptoms of depression throughout pregnancy and the early postpartum period (first trimester through six weeks postpartum) in low-income Latina women. Further, this study examined whether established risk factors in non-Latina women also predict perinatal depressive symptom trajectories in low-income Latinas.

METHODS

The sample included 240 Latina women from a federally qualified health center (FQHC).

RESULTS

Latent growth curve modeling found that, on average, symptoms of depression decreased from the first trimester of pregnancy through six weeks postpartum. Change in symptoms of depression from the first trimester through six weeks postpartum were predicted by limited English proficiency and age.

CONCLUSIONS

Findings of the current study add to existing evidence that can guide clinical care for Latina maternal mental health throughout the perinatal period.

Exploring Self-Perceived Stress and Anxiety Throughout Pregnancy: A Longitudinal Study

BACKGROUND

Anxiety and stress are common during pregnancy and can impact the health of the pregnant woman and the newborn. There is a lack of research focused on identifying weaknesses that promote equity in the care of pregnant women. The objective of this study was to describe the levels of anxiety and stress during the three trimesters of pregnancy and to compare whether there are differences according to obstetric and gynecological variables.

METHODS

A descriptive prospective longitudinal and correlational observational study was carried out. Non-probability sampling was carried out with 176 women. The Pregnancy-Related Anxiety Questionnaire and the Perceived Stress Scale were used.

RESULTS

The prevalence of anxiety was 23.9%, 17%, and 17.6%, and mean stress scores reached 32.24, 33.02, and 49.74 in the first, second, and third trimesters, respectively. In comparison, without miscarriages, anxiety was higher during the first trimester. In multiparous women who had suffered a miscarriage, anxiety was higher in the first trimester.

CONCLUSIONS

Anxiety is higher during the first trimester. Mean stress levels are higher during the third trimester compared to the other two trimesters. Care for these vulnerable pregnant women can impact society's health system and align with the Sustainable Development Goals of Health and Well-being and Gender Equality in others.

Perception and Attitude of First-Time Mothers Towards Caesarean Section in Secondary Health Care Facility (A Mixed-Method Study)

Background

Despite the global rise in caesarean section (CS), Nigeria has a CS rate of 2.8%, which is far below the World Health Organisation recommendation of 10%-15%. Primigravida and/or first-time mothers constitute a cohort of women who are prone to obstetric emergencies such as cephalo-pelvic disproportion and obstructed labour.

Objectives

To evaluate the first-time mothers' knowledge, perceptions, and attitudes towards CS.

Materials and Methods

This was a mixed-methods study conducted among first-time mothers (primigravids >28weeks and first-time CS-delivered) at Adeoyo Maternity Teaching Hospital, Ibadan, using questionnaires that assessed knowledge and attitude for the quantitative aspect and in-depth interviews for the qualitative aspect using a structured topic guide. Responses from the quantitative aspect were analysed using STATA 15, and each participant's level of knowledge was scored and categorised as: Good knowledge >70%, fair knowledge 50%-70% and poor knowledge <50%. Content analysis was done for the qualitative aspect, and emerging themes on perception and interpretation in CS were summarised and presented as results for interpretation.

Results

About 275 mothers (178 pregnant and 97 CS-delivered) were sampled. Only a few (13.45%) of the participants had good knowledge with an equivocal attitude towards CS. The majority (84%) believed that CS helped in saving lives. Also, there was a statistically significant difference between their knowledge and their educational level, occupation, religion, ethnicity, and family income (P < 0.05). The multinomial regression showed that gainfully employed Christian women significantly had more fair and good knowledge than Muslims (RR = 2.01, 95% CI = 1.13-3.57, P = 0.017) (RR = 2.71, 95% CI = 1.23-5.95, P = 0.013).

Conclusion

Only a small number of the participants had good knowledge, and their perceptions about CS varied. The attitudes of participants towards CS appeared mixed, as nearly equal proportions of participants had positive and negative attitudes. Hence, there is a need to increase advocacy, antenatal education, and counselling during antenatal clinic visits. Also, first-time mothers need to be put on insurance to reduce the burden of costs.

Social support, temperament and previous prenatal loss interact to predict depression and anxiety during pregnancy

BACKGROUND

Pregnancy is considered a complex period in a woman's life due to the changes that occur at different levels, which increase her vulnerability to developing psychological symptoms. A woman's temperament and perceived social support may play important roles in the development of such symptomatology. The main objective of the present work was to evaluate whether social support is an effective coping resource against the development of symptoms of depression and anxiety, especially among women with certain personality types, while also considering previous prenatal losses.

METHODS

The participants were 534 pregnant women in their 26th week of gestation. They completed measures related to social support, temperament (i.e. neuroticism and extraversion) and symptoms of depression and anxiety and informed us of any previous prenatal losses.

RESULTS

The association between social support and depression was negative only for women who scored high on neuroticism. Extraversion did not interact with social support to predict depression or anxiety. Additionally, temperament interacted with previous prenatal losses, playing a relevant role in the development of anxiety symptoms. Previous losses had a greater effect on women who scored low in extraversion or high in neuroticism. Finally, a triple interaction between temperament, social support and previous prenatal loss emerged, indicating that previous prenatal loss was related to anxiety in women with low social support and low extraversion.

CONCLUSION

Pregnant women, especially those who have suffered a previous prenatal loss and score high in neuroticism or low in extraversion, may benefit from interventions that enhance social support.

The course of women's emotions from early pregnancy to the postpartum period

BACKGROUND

Most studies on emotions in the perinatal period have focused on psychopathology, identifying groups of women with distinct symptom trajectories, but research on typical, normative changes in emotions across the perinatal period is scarce. This study examines typical patterns of emotions in low-risk, healthy perinatal population.

METHODS

A prospective longitudinal study with 151 participants who completed emotion-related questionnaires (Positive and Negative Affect Schedule, Perceived Stress Scale, Edinburgh Postnatal Depression Scale, State-Trait Anxiety Inventory) six times during pregnancy and twice in the postpartum. Linear mixed effect models were used to test whether maternal emotions underwent significant changes across the perinatal period and whether those changes are affected by child sex and parity. Nonlinear temporal trends were fitted by natural cubic splines.

RESULTS

For all emotions, we observed significant nonlinear changes across the perinatal period. Negative affect and anxiety decreased and positive affect increased significantly from the first to the third trimester. Depressive symptoms showed a U-shaped pattern and perceived stress remained unchanged during pregnancy. Negative affect and anxiety increased significantly from the third trimester to the first postpartum week. After stratifying for parity, the increase in negative emotions with approaching childbirth occurred only in primiparae.

CONCLUSION

Low-risk pregnancy and the early postpartum period are associated with emotional changes which differ depending on parity. Health care providers should inform pregnant women about those common changes to help them develop realistic expectations and enhance their ability to cope with the demands of pregnancy and the early postpartum period.

People with symptoms of depression and those at significant risk of suicide show differences in their personality profile and sense of meaning in life

Introduction

Medical students are exposed to various stressors. Among the many factors that determine the possibility of a mental crisis, there is also a personality profile and a sense of meaning in life.

Materials and methods

Sets of anonymous surveys were distributed among medical students of different years studying at the Medical University of Lodz. The set of surveys included a sociodemographic survey, Beck's Depression Inventory version II (BDI-II), the NEO Five Factory Inventory (NEO-FFI), Reker's Life Attitude Profile - Revised questionnaire (LAP-R), Osman's Suicidal Behavior Questionnaire (SBQ-R).

Results

The study cohort comprised of 276 students (mean age 21.7 years). According to the BDI-II, 79 participants (28.4%) were identified as having depressive symptoms. Additionally, 80 participants (28.9%) were assessed to be at significant risk of suicide according to the SBQ-R scale. Based on the results of these questionnaires, we identified four groups: 1. Participants with depressive symptoms (D). 2. Participants with suicide risk (SR), 3. Participants with both depressive symptoms with suicide risk (D and SR), 4. A control group. Students from D and D and SR groups, exhibited higher neuroticism scores compared to those with suicide risk alone (SR) and the control group. In terms of extroversion, the control and SR groups scored higher compared to the D with SR group. Participants with SR and those with D and SR had higher openness scores compared to the D and control groups. D and SR group obtained statistical lower score then control group in the terms of conscientiousness. In life control score, participants in D and D with SR group has significant lower score then SR and control group. The conditions: personal meaning index and life attitude balance in the control group achieved significantly higher values compared to all other groups.

Conclusion

People with depressive symptoms, suicide risk and both of these variables simultaneously differed in terms of personality profile and components influencing the meaning of life.

Prenatal Attachment, Personality, and Depression in High-Risk Pregnancies During Pandemic Emergencies

Background: The observational study investigates how personality factors influence depression, prenatal attachment, and fear of COVID-19 in women with high-risk pregnancies. Methods: Women experiencing a high-risk pregnancy between the 20th and 24th weeks of gestation (N = 84) were selected. The Personality Inventory (PI), Beck Depression Inventory (BDI), Prenatal Attachment Inventory (PAI), and Fear of COVID (FCV-19S) were used for data collection. Results: Agreeableness was significantly negatively correlated with fear of COVID-19 (r = -0.33, p = 0.002) and positively correlated with prenatal attachment (r = 0.28, p = 0.008). Conscientiousness was negatively correlated with prenatal attachment (r = 0.34, p = 0.001). Depression was positively correlated with fear of COVID-19 (r = 0.27, p = 0.013). Linear regressions showed that agreeableness negatively predicted fear of COVID-19 (β = -0.34, p = 0.002) and positively predicted prenatal attachment (β = 0.27, p = 0.008). Conscientiousness negatively influenced prenatal attachment (β = -0.35, p = 0.001). Conclusions: This study explores personality traits in high-risk pregnancies, a variable underexplored in this clinical population. High-risk pregnancies may lead to adverse outcomes for both mother and child.

Associations of couples' balanced time perspective with maternal prenatal hair cortisol concentration and perceived stress

OBJECTIVE

The stress experienced by a woman during pregnancy not only has a negative impact on her well-being and physical health but also adversely affects the fetus. Stress is strongly linked with time perspective, defined as the tendency to focus on the past, present, or future. The study aimed to investigate how couples' balanced time perspective was related to maternal prenatal hair cortisol concentration and perceived stress in the first and third trimesters of pregnancy.

METHOD

The participants were pregnant women and their male partners (84 couples). Women completed online questionnaires: the Zimbardo Time Perspective Inventory (ZTPI), the Dark Future Scale (DFS), and the Perceived Stress Scale, while men completed online versions of the ZTPI and the DFS. These questionnaire measurements were conducted in the first and third trimesters. Maternal cortisol levels were measured in hair samples taken during gynecological visits, in the first and third trimesters.

RESULTS

The study revealed that the more unbalanced the partner's time perspective, the more unbalanced the pregnant woman's time perspective and, consequently, the higher the stress perceived by the pregnant woman. This effect was present in both the first (B = 1.06, SE =.36, p <.001, 95 % CI [.398, 1.826]) and the third trimesters (B =.98, SE =.36, p <.001, 95 % CI [.327, 1.774]). Moreover, the more unbalanced the partner's time perspective, the more unbalanced the woman's time perspective and, consequently, the lower the hair cortisol concentration in the first trimester (B = -.08, SE =.04, p <.05, 95 % CI [-.171, -.010]). Partner's unbalanced time perspective in the first trimester was also a predictor of stress perceived by the woman in the third trimester (t = 2.38, p <.05).

CONCLUSIONS

The results suggest the significance of the partner's time perspective for the pregnant woman's mental health. The partner's unbalanced, negative time perspective in the first trimester may increase the pregnant woman's stress in the third trimester. This effect can be even stronger than that of the woman's time perspective.

Treatment gap and barriers to access mental healthcare among women with postpartum depression symptoms in Pakistan

BACKGROUND AND OBJECTIVES

Postpartum depression (PPD) is prevalent among women after childbirth, but accessing mental healthcare for PPD is challenging. This study aimed to assess the treatment gap and barriers to mental healthcare access for women with PPD symptoms living in Punjab, Pakistan.

METHODS

A multicenter cross-sectional study was conducted in five populous cities of Punjab from January to June 2023 by administering the questionnaire to the women using stratified random sampling. A total of 3,220 women in first 6 months postpartum were screened using the Edinburgh Postnatal Depression Scale. Of them, 1,503 women scored thirteen or above, indicating potential depressive disorder. Interviews were conducted to explore help-seeking behavior and barriers to accessing mental healthcare. Descriptive statistics along with nonparametric tests (e.g., Kruskal-Wallis, Mann-Whitney U) were used and group differences were examined. Scatter plot matrices with fitted lines were used to explore associations between variables. Classification and regression tree methods were used to classify the importance and contribution of different variables for the intensity of PPD.

RESULTS

Only 2% of women (n = 33) with high PPD symptoms sought mental healthcare, and merely 5% of women (n = 75) had been in contact with a health service since the onset of their symptoms. 92.80% of women with PPD symptoms did not seek any medical attention. The majority of women, 1,215 (81%), perceived the need for mental health treatment; however, 91.23% of them did not seek treatment from healthcare services. Women who recently gave birth to a female child had higher mean depression scores compared to those who gave birth to a male child. Age, education, and birth location of newborn were significantly associated (p  <  0.005) with mean barrier scores, mean social support scores, mean depression scores and treatment gap. The results of classification and regression decision tree model showed that instrumental barrier scores are the most important in predicting mean PPD scores.

CONCLUSION

Women with PPD symptoms encountered considerable treatment gap and barriers to access mental health care. Integration of mental health services into obstetric care as well as PPD screening in public and private hospitals of Punjab, Pakistan is critically needed to overcome the treatment gap and barriers.

Transition to Motherhood and Lived Experiences of Teenage Mothers Delivering in Kasese and Bundibugyo Districts, Western Uganda

Introduction A large number of teenagers in low-resource settings experience pregnancy, with a significant number of these cases happening in sub-Saharan Africa. Teenage pregnancy is associated with unique physical and psychological experiences. Objective To explore the lived experiences of teenage mothers delivering at a tertiary referral hospital in southwestern Uganda. Methods This qualitative study used focus group discussions (FGDs) with teenage mothers in Kasese and Bundibugyo districts in Uganda. We purposively sampled 32 teenage mothers attending a tertiary referral hospital who had been pregnant at least once and had given birth. Sociodemographic information was obtained, and FGDs were conducted to capture the teenagers' experiences transitioning to motherhood. An inductive content analytic approach was used to analyze data.  Results The mean age of the participants was 18.4 (standard deviation [SD], 1.2) years, with the majority (22, 68.8%) being rural dwellers, married (23, 71.9%), unemployed (21, 65.6%), and having attained primary education (23, 71.9%). Teenage mothers' lived experiences were characterized by shattered dreams, concerns about changes in their body size and shape, abandonment and neglect by family members and spouses, considerations of terminating the pregnancy, forced early marriages, family stereotypes, and engaging in sex for survival. The process of transitioning to motherhood occurred along with resilience post-pregnancy and supportive environments from their loved ones, which enabled them to accept reality and care for their children. Conclusions The lived experiences of teenage mothers demonstrated social pressures, fear of abandonment, and poverty as major influences on their mindset and behavior. Further research to gain a comprehensive understanding of the challenges encountered by teenage mothers will aid the development of culturally appropriate strategies to reduce teenage pregnancy and improve perinatal outcomes.

Social support as a coping resource for psychosocial conditions in postpartum period: a systematic review and logic framework

PURPOSE

This review seeks to examine the current state of postpartum social support and psychosocial conditions among women around the world, as well as explore the relationship between these factors. Additionally, it aims to propose a logical framework for enhancing postpartum social support and psychosocial conditions in this population.

METHODS

Following the development of a search strategy, two databases, PubMed and Science Direct, were searched for studies published between January 2019 and May 2023. The search was conducted throughout the entire month of May 2023. The risk of bias in the included cross-sectional studies was assessed using the Newcastle-Ottawa Quality Assessment Scale, which was adapted for this specific study design. To determine if the main objective of the cross-sectional studies was to investigate the relationship between social support and postpartum psychosocial conditions, a review was conducted based on the AMSTAR checklist, PRISMA checklist and PRISMA flow diagram. Data extraction was performed with the consensus of two authors, and a narrative synthesis approach was chosen for data synthesis, following the guidelines provided by the Centre for Reviews and Dissemination (CRD).

RESULTS

Eleven cross-sectional studies were included in the final analysis. Our findings revealed that all reviewed studies provided evidence of a positive association between social support and healthy psychosocial conditions in postpartum period. However, due to the absence of standardized measurement indicators to identify and compare the outcomes of various studies, there was a need to develop a conceptual framework that could enhance our understanding of the postpartum psychosocial condition including anxiety, depression, unfavorable quality of life and social support status up to 24 month after child birth. This framework aimed to incorporate childbirth and motherhood as "stressful events," while considering social support as a crucial "coping resource." Furthermore, it acknowledged empowerment, help-seeking behavior, and peer support as important "coping actions," alongside implementing client-centered interventions. Lastly, it recognized postpartum mental health and optimal quality of life as significant "effects" of these factors.

CONCLUSIONS

The proposed conceptual framework could define postpartum women's health as "the ability to adapt and self-manage."

Young women's social support networks during pregnancy in Soweto, South Africa

BACKGROUND

Although studies from high-income countries have examined social support during pregnancy, it remains unclear what type of support is received by expectant mothers from low- and middle-income country settings.

AIM

To explore young women's social support networks during pregnancy in Soweto, South Africa.

SETTING

This study was undertaken in an academic hospital based in the Southwestern Townships (Soweto), Johannesburg, in Gauteng province, South Africa.

METHODS

An exploratory descriptive qualitative approach was employed. Eighteen (18) young pregnant women were recruited using a purposive sampling approach. In-depth interviews were conducted, and data were analysed using inductive thematic analysis.

RESULTS

Analysis of the data resulted in the development of two superordinate themes namely; (1) relationships during pregnancy and (2) network involvement. Involvement of the various social networks contributed greatly to the young women having a greater sense of potential parental efficacy and increased acceptance of their pregnancies. Pregnant women who receive sufficient social support from immediate networks have increased potential to embrace and give attention to pregnancy-related changes.

CONCLUSION

Focusing on less-examined characteristics that could enhance pregnant women's health could help in the reduction of deaths that arise because of pregnancy complications and contribute in globally accelerating increased accessibility to adequate reproductive health.Contribution: This study's findings emphasise the necessity for policymakers and healthcare providers to educate the broader community about the importance of partner, family and peer support to minimise risks that may affect pregnancy care and wellbeing of mothers.

Effect of childbirth experience on the psychological well-being of postpartum women in Accra, Ghana

BACKGROUND

Women's experience of childbirth can affect their mental health outcomes, many years after the delivery. Consequently, the World Health Organisation has provided recommendations to ensure women receive positive birth experiences during intrapartum care. Yet, negative childbirth experience is widespread in Ghana. This study examined the association between women's childbirth experience (i.e. own capacity, professional support, perceived safety, and participation) and their psychological well-being, and whether or not perceived social support and resilience moderate the childbirth experience - psychological well-being relationship.

METHODS

Mothers (N = 117) who had given birth in the past month and were receiving postnatal care at two health facilities in the Greater Accra Region of Ghana provided the data for the current analysis. Data were collected using the Childbirth Experience Questionnaire, WHO-5 Well-Being Index, Multidimensional Scale of Perceived Social Support, and Brief Resilience Scale. Hierarchical Linear Regression was used to analyse the data.

RESULTS

Results showed that childbirth experience domains of own capacity and perceived safety were significantly, and positively associated with psychological well-being. The domains of professional support and participation were not associated with psychological well-being in this sample. Perceived social support and resilience did not moderate the association between childbirth experience and psychological well-being.

CONCLUSION

The results suggest that efforts by birth practitioners (i.e. midwives, obstetricians, and gynaecologists) to give Ghanaian women positive childbirth experiences through the encouragement of personal control over the birthing process as well as ensuring the safety of the birthing procedure and environment would provide women with optimal mental health outcomes.

Women's experiences of social support during pregnancy: a qualitative systematic review

BACKGROUND

Social support during pregnancy can alleviate emotional and physical pressures, improving the well-being of mother and child. Understanding women's lived experiences and perceptions of social support during pregnancy is imperative to better support women. This systematic review explores and synthesises the qualitative research on women's experiences of social support during pregnancy.

METHODS

Databases PubMed, CINAHL, MEDLINE, APA PsycInfo and Scopus were searched with no year limit. Eligible studies included pregnant women or women who were up to one year postpartum and were assessed on their experiences of social support during pregnancy. The data were synthesised using the thematic synthesis approach.

RESULTS

Fourteen studies were included with data from 571 participating women across ten countries; two studies used focus groups, and 12 used interviews to collect their data. Four main themes were developed ('a variety of emotional support', 'tangible and intangible instrumental support', 'traditional rituals and spiritual support', and 'the all-encompassing natal home'), and six sub-themes ('female network connections', 'care and affection from the husband', 'dissatisfaction with relationships', 'financial support from the husband and family', 'practical support from family and friends', 'health information support').

CONCLUSIONS

This systematic review sheds light on women's experiences of social support during pregnancy. The results indicate a broad variety of emotional support experienced and valued by pregnant women from different sources. Additionally, women expressed satisfaction and dissatisfaction with tangible and intangible support forms. It was also highlighted that spirituality played an essential role in reducing stress and offering coping mechanisms for some, whereas spirituality increased stress levels for others.

The impact of prepartum pandemic-related perceived stress on anxiety symptoms in the postpartum: The role of perceived childbirth experiences

Postpartum anxiety is a significant component of postpartum maternal distress and is related to adverse outcomes for both the mother and the child. Although previous research reported higher anxiety symptoms in pregnant women during the Covid-19 pandemic, no studies evaluated the negative impact of pandemic-related perceived stress on postpartum anxiety symptomatology over time. This study aimed to examine the impact of prepartum pandemic-related stress on postpartum anxiety and to evaluate the role of subjective labor and delivery experiences on this relationship. A sample of 172 pregnant women completed an online questionnaire evaluating pandemic-related perceived stress and anxiety symptoms in the second or third trimester of pregnancy. In the postpartum, they completed a second questionnaire retrospectively evaluating their childbirth experience and assessing anxiety symptoms in the last two weeks. A mediation analysis was conducted. Prepartum pandemic-related perceived stress was significantly associated with postpartum anxiety symptoms. Moreover, childbirth experiences significantly and partially mediated this relationship. Findings highlighted the importance of evaluating perceived stress levels during pregnancy to prevent negative consequences on postpartum mental health. Clinicians need to foster better management of factors included in the childbirth experience that may potentially trigger or counteract anxiety risk.

The effect of perceived social support on postpartum stress: the mediating roles of marital satisfaction and maternal postnatal attachment

BACKGROUND

Multiple factors may be responsible for the development of postpartum stress, including perceived social support, marital satisfaction, and maternal postnatal attachment. However, the underlying mediation mechanisms remain unclear. This study examined the complex relationships between perceived social support and postpartum stress among Chinese women.

METHODS

A convenience sample comprising 406 postpartum women was recruited from six hospitals in Nantong, Jiangsu Province, China. The participants completed general survey questionnaires and were evaluated using the Maternal Postpartum Stress Scale, the Perceived Social Support Scale, the Maternal Postnatal Attachment Scale, and the Marital Satisfaction Scale. Furthermore, we evaluated the relationship between postpartum stress and the various influencing factors by performing a multiple linear regression analysis. The potential mediating roles of marital satisfaction and maternal and infant attachment in the association between perceived social support and postpartum stress were explored by performing a mediation analysis.

RESULTS

According to the multivariate regression analysis, perceived social support, marital satisfaction, and maternal postnatal attachment contributed to postpartum stress levels (P < 0.05). The mediation analysis revealed that marital satisfaction and maternal postnatal attachment played parallel mediating roles in the association between perceived social support and postpartum stress, and the mediating effect of marital satisfaction was - 0.1125 (95% confidence interval [CI]: -0.1784 to -0.0520), accounting for 33.20% of the total effect, and the mediating effect of maternal postnatal attachment was - 0.0847 (95% CI: -0.1304 to -0.0438), accounting for 25.00% of the total effect.

CONCLUSION

Our study revealed that perceived social support could influence postpartum stress not only through direct effect (41.80% of the total effect), but also through the indirect effect (mediation effect) of marital satisfaction and maternal postnatal attachment (58.20% of the total effect), suggesting that improving postpartum women's social support, enhancing maternal and infant attachment, and improving their marital satisfaction could help lower postpartum stress.

Maternal Adverse Childhood Experiences and Perceived Stress During Pregnancy: The Role of Personality

This study explores the role of personality traits in the relationship between maternal adverse childhood experiences (ACEs) and perceived stress during pregnancy. Pregnancy can be a stressful time for new mothers. ACEs have been associated with elevated levels of pregnancy stress, and have also been linked to the Big Five dimensions of personality, including a positive association with neuroticism. The Big Five have also been associated with perceptions of stress, and there is evidence to suggest that personality may be one mechanism through which ACEs disrupt psychosocial functioning during pregnancy. The sample included 177 pregnant girls and women (ages 15-40) from two prenatal clinics serving diverse and low-income patients. Participants completed online questionnaires on perceived stress, ACEs, and the Ten Item Personality Inventory. Results of a path analysis and test of mediation showed significant indirect effects from ACEs to perceived stress mediated independently by neuroticism and conscientiousness. Mothers with high ACEs reported higher neuroticism and lower conscientiousness, and in turn, experienced high levels of perceived stress during pregnancy. High neuroticism and low conscientiousness associated with early adverse experiences increase the risk for perceived stress during pregnancy. Screening for ACEs may help identify mothers at risk for perinatal stress and provide the opportunity for additional support for maternal emotion regulation and mental health.

Social support for postpartum women and associated factors including online support to reduce stress and depression amidst COVID-19: Results of an online survey in Thailand

BACKGROUND

Social support for postpartum women helps mothers to recover from childbirth and fosters healthy infant development. However, the impacts of reduced interpersonal interactions inflicted by the COVID-19 outbreak on available social support for postpartum women have received little attention. Therefore, this study aimed to examine the levels of social support provided to postpartum women and associated factors in Thailand during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted from July to October 2021 using an anonymous online questionnaire. The responses of 840 eligible women up to six months postpartum in Thailand were obtained. The maternity social support scale was used to measure social support. Multivariate logistic regression was used to analyse the factors associated with social support among postpartum women.

RESULTS

About 57% of women reported to receive high support. Women in the high social support group were more likely to be married (aOR:2.70; 95% CI:1.57-4.66), have a university education or above (1.88; 1.35-2.64), have an intended pregnancy (2.06; 1.34-3.16), good health (2.01; 1.44-2.81), good sleep quality (1.62; 1.14-2.31), receive counsel from peers or family (1.56; 1.13-2.16), and use internet or social media to reduce stress and depression (1.51; 1.08-2.11). Meanwhile, women in the high social support group were significantly less likely to feed complementary foods to infants within 24 hours of completing the survey (0.28; 0.15-0.52).

CONCLUSIONS

The results of this study indicated that more than half of the women reported high support and illustrated the important role played by family, peers, and professionals as well as online and remote channels in providing postpartum informational and emotional support during the pandemic. Online platforms and remote support may be considered to provide social support to postpartum women during a pandemic such as COVID-19.

Depression, anxiety, and stress in pregnancy and postpartum: A longitudinal study during the COVID-19 pandemic

INTRODUCTION

Symptoms of depression, anxiety, and stress in pregnant women are generally highest in the first trimester and then decrease throughout pregnancy, reaching their lowest point in the postpartum period. Pregnant women are a high-risk population for mortality and mental health symptoms due to COVID-19. However, the extent to which the chronic stress of the COVID-19 pandemic alters the trajectory of depression, anxiety and stress symptoms in pregnant/postpartum women is unknown.

METHODS

Women (N=127) who were pregnant or who had given birth less than one month prior were recruited via online advertising during the COVID-19 pandemic. Participants were assessed up to three times during the pregnancy and at 1-month postpartum for depression (Edinburgh Postnatal Depression Scale), anxiety, and stress (Depression, Anxiety, and Stress Scale-21). Random intercepts models examined symptom change over time as well as predictors of elevated postpartum psychopathology.

RESULTS

On average, women completed their surveys at 8.5 weeks (first trimester), 21 weeks (second trimester), 32 weeks (third trimester) and 7-weeks postpartum. Women reported mild-moderate levels of depression, anxiety, and stress throughout pregnancy. There was a significant change in symptoms of depression and anxiety over time which was best represented by a quadratic rather than linear trajectory: symptoms increased until week 23-25 and then decreased. Stress levels remained consistently elevated over time. Higher symptom levels at 1-month postpartum were predicted by younger age, lower social support, and worry about going to a healthcare facility. Change in routine due to COVID-19 was not predictive of symptom trajectory from pregnancy to postpartum.

CONCLUSIONS

During COVID-19, symptoms of depression and anxiety increased from early to mid-pregnancy but then declined slightly while stress levels remained elevated. Observed reductions in symptoms were small. Given the substantial persistent impact of perinatal distress and poor mental health on maternal and fetal health, providers should be aware of heightened levels of these symptoms in pregnant women during large-scale external health stressors such as COVID-19, and should implement screening procedures to identify and appropriately intervene with at-risk women.

Psychological Characteristics of Women with Perinatal Depression Who Require Psychiatric Support during Pregnancy or Postpartum: A Cross-Sectional Study

Antenatal depression may be distinct from postpartum depression in terms of prevalence, severity of symptoms, comorbidities, prognosis, and risk factors. Although risk factors for perinatal depression have been identified, it is unclear whether there are differences in the onset of perinatal depression (PND). This study explored the characteristics of women requiring mental health support during pregnancy or postpartum. A sample of 170 women (58% in pregnancy; 42% postpartum) who contacted the SOS-MAMMA outpatient clinic was recruited. Clinical data sheets and self-report questionnaires (EPDS, LTE-Q, BIG FIVE; ECR; BSQ; STICSA) were administered, hypothesizing possible risk factors, such as personality traits, stressful life events, body dissatisfaction, attachment style, and anxiety. Hierarchical regression models were carried out in the pregnancy (F_10;36 = 8.075, p < 0.001, adjR2 = 0.877) and postpartum groups (F_10;38 = 3.082, p < 0.05, adjR2 = 0.809). Recent stressful life events and conscientiousness were associated with depression in both the pregnant (29.3%, 25.5% of variance) and postpartum groups (23.8%, 20.7% of variance). In pregnant women, "openness" (11.6%), body dissatisfaction (10.2%), and anxiety (7.1%) symptoms were predictive of depression. In the postpartum group, "neuroticism" (13.8%) and insecure romantic attachment dimensions (13.4%; 9.2%) were the strongest predictors. Perinatal psychological interventions should consider the differences between mothers with depression during pregnancy and postpartum.

The Pandemic Anxiety Inventory: A validation study

The Pandemic Anxiety Inventory (PAI) assesses anxiety symptoms individuals attribute to the presence of a pandemic. We conducted this study of 379 British adults during the COVID-19 pandemic and found that the PAI exhibited excellent reliability and solid criterion validity. Pandemic anxiety was associated with reduced social support, anticipated life changes, financial strain, job loss, economic insecurity, and the hospitalization or death of a close friend or relative. Using correlational and bifactor analyses, we found that the PAI demonstrated solid convergent and discriminant validity. The findings suggest that the PAI can be used in research and clinical practice.

The association between history of prenatal loss and maternal psychological state in a subsequent pregnancy: an ecological momentary assessment (EMA) study

BACKGROUND

Prenatal loss which occurs in approximately 20% of pregnancies represents a well-established risk factor for anxiety and affective disorders. In the current study, we examined whether a history of prenatal loss is associated with a subsequent pregnancy with maternal psychological state using ecological momentary assessment (EMA)-based measures of pregnancy-specific distress and mood in everyday life.

METHOD

This study was conducted in a cohort of N = 155 healthy pregnant women, of which N = 40 had a history of prenatal loss. An EMA protocol was used in early and late pregnancy to collect repeated measures of maternal stress and mood, on average eight times per day over a consecutive 4-day period. The association between a history of prenatal loss and psychological state was estimated using linear mixed models.

RESULTS

Compared to women who had not experienced a prior prenatal loss, women with a history of prenatal loss reported higher levels of pregnancy-specific distress in early as well as late pregnancy and also were more nervous and tired. Furthermore, in the comparison group pregnancy-specific distress decreased and mood improved from early to late pregnancy, whereas these changes across pregnancy were not evident in women in the prenatal loss group.

CONCLUSION

Our findings suggest that prenatal loss in a prior pregnancy is associated with a subsequent pregnancy with significantly higher stress and impaired mood levels in everyday life across gestation. These findings have important implications for designing EMA-based ambulatory, personalized interventions to reduce stress during pregnancy in this high-risk group.

Quality assessment of pre- and postnatal nutrition and exercise mobile applications in the United States and China

Background

Mobile applications (apps) are becoming increasingly prevalent as tools for improving maternal health behaviors. However, the recently updated content and quality of these apps remain unknown. This research investigated the fundamental characteristics, functional modules, and overall quality of maternal apps available in the United States and China to reveal critical nutrition and physical activity gaps.

Methods

A systematic search was performed in Android and iOS app stores (China and the United States). Apps were eligible if they targeted pregnant or postpartum women, focused on nutrition or physical activity, and had interfaces in English or Chinese. The basic characteristics, functional modules, and overall quality of the apps were evaluated, and differences between apps available in China or the United States were determined using analysis of variance and chi-square tests. Pearson correlations were utilized to investigate links between objective quality and user rating.

Results

A total of 65 maternity-related nutrition and physical activity apps (34 from China and 31 from the United States) were eligible. Among them, 68% (21/31) of US apps and 56% (19/34) of Chinese apps did not provide supporting evidence for their content. A greater number of Chinese apps provided app-based general education modules, namely food nutrition knowledge (n = 0, 0% in the United States vs. n = 30, 88.2% in China). Meanwhile, a greater number of US apps provided exercise modules, namely pregnancy yoga (n = 21, 67.7% in the United States vs. n = 2, 5.9% in China). The overall app quality rating in the United States was lower than it was in China (mean: 3.5, SD: 0.6 in China vs. mean: 3.4, SD: 0.7 in the United States). There was no relationship between the overall app quality rating and the user rating in either country (rho = 0.11 in China and rho = -0.13 in the United States).

Conclusion

The characteristics and functional modules of in-store apps for maternal nutrition and physical activity differed between the United States and China. Both countries' apps, especially Chinese apps, lacked evidence-based information, and there was no correlation between app quality and user rating. The results therefore suggest that user ratings cannot be used as an objective indicator of app quality and that it is necessary to improve the empirical basis and credibility of apps in both countries.

Individual Characteristics and Pain Sensitivity during Pregnancy-A Cross-Sectional Study in Pregnant and Non-Pregnant Women

The aim of the study was to describe the characteristics and factors related to pain perception in pregnant women, such as optimism, personality traits, and fear of developing COVID-19 consequences. Sixty-six pregnant women aged 23 to 42 years participated in the study, and the comparison group consisted of n = 59 non-pregnant female students aged 19 to 23 years. Pressure pain threshold and pain tolerance were measured with an algometer. To assess psychological characteristics, the Life-Orientation Test-Revised was used to assess optimism, the Fear of COVID-19 Scale was used to assess COVID-19 anxiety, and the Ten-Item Personality Inventory was applied to assess personality traits in a five-factor model. The main results of the study showed that pain tolerance was significantly lower in both dominant and non-dominant hand pregnant women than in the comparison group. The studied pregnant women had higher scores for conscientiousness, fear of COVID-19, and optimism compared with the non-pregnant women. Regression analysis showed that the variability in pain perception among pregnant women could not be explained by individual differences in personality traits, optimism, and fear of COVID-19.

Social connectedness as a determinant of mental health: A scoping review

Public health and epidemiologic research have established that social connectedness promotes overall health. Yet there have been no recent reviews of findings from research examining social connectedness as a determinant of mental health. The goal of this review was to evaluate recent longitudinal research probing the effects of social connectedness on depression and anxiety symptoms and diagnoses in the general population. A scoping review was performed of PubMed and PsychInfo databases from January 2015 to December 2021 following PRISMA-ScR guidelines using a defined search strategy. The search yielded 66 unique studies. In research with other than pregnant women, 83% (19 of 23) studies reported that social support benefited symptoms of depression with the remaining 17% (5 of 23) reporting minimal or no evidence that lower levels of social support predict depression at follow-up. In research with pregnant women, 83% (24 of 29 studies) found that low social support increased postpartum depressive symptoms. Among 8 of 9 studies that focused on loneliness, feeling lonely at baseline was related to adverse outcomes at follow-up including higher risks of major depressive disorder, depressive symptom severity, generalized anxiety disorder, and lower levels of physical activity. In 5 of 8 reports, smaller social network size predicted depressive symptoms or disorder at follow-up. In summary, most recent relevant longitudinal studies have demonstrated that social connectedness protects adults in the general population from depressive symptoms and disorders. The results, which were largely consistent across settings, exposure measures, and populations, support efforts to improve clinical detection of high-risk patients, including adults with low social support and elevated loneliness.

Association between social support and pregnancy stress: a cross-sectional study of neighbors’ interactions

Background

Pregnancy is associated with substantial stressful experiences. There are controversies concerning the positive and negative roles of social support during pregnancy. This research aimed to study the association of social support with the pregnancy-related stress.

Methods

In the current cross-sectional research, 200 pregnant women were recruited through convenience sampling from two teaching hospitals affiliated with Babol University of Medical Sciences and a private obstetric clinic. The women completed two self-reported questionnaires during prenatal care appointments. The questionnaires included the Revised Prenatal Distress Questionnaire (NuPDQ) and Social Support Questionnaire (SSQ).

Results

A significantly positive association was observed between the social support of neighbors and the total score of pregnancy stress (P<0.001), as well as the scores of its four subscales, namely medical problems (P<0.001), parenting (P=0.25), infant health stress (P=0.006), and pregnancy symptoms (P=0.001). Based on the linear regression models, the social support of neighbors was significantly related to the medical problem-associated stress in pregnant women (β = 0.147, 95% CI: 0.14 to 0.62, p = 0.047), pregnancy symptom (β = 0.203, 95% CI: −0.01 to 0.327, p = 0.017), and fear of childbirth (β = 0.164, 95% CI: 0.05 to 0.38, p = 0.046). Furthermore, the neighbors’ social support (β = 0.172, 95% CI: 0.02 to 0.32, p = 0.04) and the total score of social support (β = 0.155, 95% CI: 0.01 to 0.304, p = 0.046) were significantly associated with the total score of pregnancy stress.

Conclusions

Neighbors’ support, as a component of social support, was found to be significantly related to pregnancy stress. This study recommends that healthcare providers consider the positive and negative impacts of social support during the pregnancy period.

Personality growth after relationship losses: Changes of perceived control in the years around separation, divorce, and the death of a partner

Background

Previous research suggests that romantic relationships play a crucial role for perceived control. However, we know surprisingly little about changes in perceived control before and after the end of romantic relationships.

Methods

Based on data from the Socio-Economic Panel Study (SOEP), a nationally representative household panel study from Germany, we examined changes of perceived control in the years around separation from a partner (N = 1,235), divorce (N = 423), and the death of a partner (N = 437).

Results

Multilevel analyses revealed that external control beliefs were higher in but not beyond the first year after separation from a partner. Internal and total control beliefs increased gradually in the years after separation. Moreover, internal control beliefs were higher in and especially beyond the first year after the death of a partner compared to the years before. No evidence was found that perceived control already changed in the years before relationship losses or in the years around a divorce.

Conclusion

Taken together, these findings point toward stress-related growth of perceived control after some relationship losses–especially separation and the death of a partner.

A qualitative analysis of feelings and experiences associated with perinatal distress during the COVID-19 pandemic

Background

Rates of perinatal mental health difficulties (experienced during pregnancy and the 12-months postpartum) increased worldwide during the COVID-19 pandemic. In the UK, anxiety and depression were estimated to affect more than half of perinatal women during the first national lockdown. However, little is known about women’s qualitative experiences of distress. This study aimed to extend published quantitative findings resulting from the same data set (Harrison et al., Women Birth xxxx, 2021;  Harrison et al., J Reprod Infant Psychol 1–16, 2021) to qualitatively explore: 1) the feelings and symptoms associated with maternal perinatal distress during the COVID-19 pandemic; and 2) the associated sources of distress.

Methods

As part of an online survey during May 2020, 424 perinatal women responded to an open-ended question regarding a recent experience of distress. Qualitative data were analysed using an initial content analysis, followed by an inductive thematic analysis adopting a realist approach. Data were explored in the context of self-reported perinatal anxiety and depression symptoms.

Results

Initial content analysis of the data identified twelve distinct categories depicting participants’ feelings and symptoms associated with psychological distress. Despite the high rates of probable depression in the sample, women’s descriptions were more indicative of anxiety and general distress, than of symptoms traditionally related to depression. In terms of the associated psychosocial stressors, a thematic analysis identified five themes: Family wellbeing; Lack of support; Mothering challenges; Loss of control due to COVID-19; and Work and finances. Unsurprisingly given the context, isolation was a common challenge. Additionally, psychological conflict between maternal expectations and the reality of pregnancy and motherhood, loss of autonomy and control, and fears surrounding family health, safety, and wellbeing underlay many of the themes.

Conclusions

This study presents an array of feelings and symptoms expressed by perinatal mothers which may be useful to consider in relation to perinatal wellbeing. Furthermore, our data highlights several common sources of distress, including multiple COVID-19 specific factors. However, many were related to more general perinatal/maternal experiences. Our findings also point to considerations that may be useful in alleviating distress in pregnancy and early motherhood, including social support, realistic perinatal/maternal expectations, and support for those with perceived perinatal trauma.

The role of psychological self-care on worry of vaccination against COVID-19 in Iranian pregnant women: A cross-sectional study

BACKGROUND AND AIMS

Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID-19 in pregnant women, the role of psychological self-care is unclear. The present study aimed to investigate the role of psychological self-care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID-19.

METHODS

The present cross-sectional study was conducted during the peak of the Delta variant of COVID-19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self-care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination-3 inventory.

RESULTS

Pregnant women were in relatively good condition based on psychological self-care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self-care of pregnant women which negatively predicted the depressive symptoms (β = -0.311, p < 0.001), anxiety symptoms (β = -0.269, p < 0.001), psychological distress (β = -0.269, p < 0.001), and worry of vaccination against COVID-19 (β = -0.214, p < 0.001).

CONCLUSION

Women's psychological self-care plays a protective role against the depressive symptoms, anxiety symptoms, psychological distress, and worry of vaccination against COVID-19 during pregnancy. Clinicians need to pay more attention to the role of psychological self-care as an important factor in preventing the symptoms of anxiety and depression during regular pregnancy visits.

Psychosocial predictors of mental health among pregnant women

PURPOSE

The vulnerability and prevalence of common psychiatric illnesses, that is, anxiety and depression are very high at the time of pregnancy in the socio-cultural context of Southeast Asian low- middle-income countries' pregnant women. However, the issue remains poorly understood despite the fact that pregnancy can be stressful for women, their families and is strongly connected with marital quality and perceived social support. The present study examines the impact of anxiety proneness, marital satisfaction, and perceived social support on fear of childbirth and development of depression among pregnant women.

DESIGN AND METHODS

Participants were purposively selected 136 pregnant women who were in the third trimester with ages ranging between 19 and 35 years and were selected through a purposive sampling technique from six hospitals in Pakistan. The STICSA, RAS, MSPSS, CAQ, and PADQ scales and questionnaires were used as study tools.

FINDINGS

Anxiety proneness positively predicted childbirth fear and depression; marital satisfaction and perceived presence of social support were negative predictors among pregnant women.

PRACTICE IMPLICATIONS

Obstetricians, nurses, midwives, and mental health professionals can imply these findings towards developing targeted antenatal programs that focus on the pregnant woman's mental health.

Facet-level changes in mothers’ neuroticism and extraversion from early pregnancy to 6 months post-partum

Becoming a parent could be expected to affect personality development, but the existing results on parenthood-personality change connection are mixed. The present study investigated 2445 primi- and multiparous mothers’ facet- and domain-level changes in Neuroticism and Extraversion from early pregnancy to 6 months post-partum, using latent difference score models. The results showed that Excitability and the affective facets of Neuroticism decreased, and the Neuroticism facets Impulsivity and Self-Consciousness increased during the follow-up. Furthermore, mother-perceived child difficult temperament attenuated desirable personality change and amplified the increases in Impulsivity. The results suggested that considering facet-level changes in personality development across significant life events is informative, and that mother-perceived child temperament may represent an important moderator of short-term personality change across the transition to parenthood.

The Relationship between Social Support and Postnatal Anxiety and Depression: Results from the Listening to Mothers in California Survey

BACKGROUND

Perinatal mood and anxiety disorders (PMADs) impact multiple domains of maternal and child well-being. Estimates of postpartum depressive symptoms range from 6.5% to 12.9% and from 8.6% to 9.9% for postpartum anxiety. We sought to identify the role social support could play in mitigating PMADs.

METHODS

The data are drawn from the Listening to Mothers in California survey; results are representative of women who gave birth in 2016 in a California hospital. The Patient Health Questionnaire-4 was used to assess total symptoms of PMADs and anxiety and depressive symptoms individually. Two questions adapted from the Medical Outcomes Study Social Support Survey were used to assess emotional, practical, and functional (combined) social support. After exclusions for missing data related to PMADs or social support, we analyzed data from 2,372 women.

RESULTS

At the time of survey administration (mean 5.7 months after birth), 7.0% of respondents reported elevated PMAD symptoms and 45.9% reported that they always received functional social support. In multivariable analysis, controlling for demographic and pregnancy-related factors and prenatal anxiety and depressive symptoms, women who reported consistent support had a prevalence of elevated PMAD symptoms one-half that of those who did not (adjusted odds ratio, 0.50; 95% confidence interval, 0.34-0.74).

CONCLUSIONS

This study suggests that consistent social support serves as a robust protective factor against postpartum symptoms of PMADs. Because many predictors of PMADs are not modifiable, social support stands out as an important target for programmatic intervention, particularly in light of increased isolation related to the COVID-19 pandemic.

Maternal personality and postpartum mental disorders in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Personality has been shown to predict postpartum depressive symptoms (PDS) assessed by the Edinburgh Postnatal Depression Scale (EPDS). However, existing studies have not considered the underlying symptom dimensions in the EPDS. We analyzed data from 15,012 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Personality was assessed in middle pregnancy using the short-form Eysenck Personality Questionnaire-Revised. PDS were defined as EPDS score ≥ 9 at 1 month after delivery. The EPDS items were further divided into three dimensions: depressed mood, anxiety, and anhedonia. Multiple analyses were conducted to examine the associations of each personality scale with PDS and three dimensions in the EPDS, adjusting for age, parity, mode of delivery, education, income, and social isolation. The prevalence of PDS assessed by the EPDS at 1 month after delivery was 13.1%. Higher neuroticism scores were associated with PDS (odds ratio [OR], 2.63; 95% confidence interval [CI], 2.48 to 2.79) and all three dimensions (all p < 0.001). Lower extraversion scores were associated with PDS (OR, 0.74; 95% CI, 0.70 to 0.78) and all three dimensions (all p < 0.001). Lower psychoticism scores were associated with PDS (OR, 0.89; 95% CI, 0.85 to 0.94) and anxiety (p < 0.001), but not with depressed mood (p = 0.20) or anhedonia (p = 0.92). In conclusion, higher neuroticism and lower extraversion were associated with PDS and the three underlying dimensions in the EPDS, while lower psychoticism was associated with anxiety, but not with depressed mood or anhedonia.

Physical and mental health changes in the five years before and five years after childbirth: A population-based panel study in first-time mothers and fathers from Germany

BACKGROUND

The transition to parenthood is characterized by far-reaching changes in life. However, little prospective-longitudinal evidence from general population samples exists on changes of general physical and mental health in the years around the birth of a child among mothers and fathers.

METHODS

Using data from the German Socio-Economic Panel Study (SOEP), this study examined continuous and discontinuous short- and long-term changes of general physical and mental health from five years before until five years after the birth of the first child in women (N = 1,912) and men (N = 1,742). Whether a child was born was assessed annually throughout the study. Physical and mental health was assessed biannually from 2002 to 2018 with the SF-12v2.

RESULTS

Multilevel analyses revealed that women experienced a considerable decrease of physical health during pregnancy, which remitted after delivery. On average, women's mental health increased in the last year before and first year after delivery. These mental health improvements were stronger in older vs. younger mothers and remained largely stable in the years after childbirth. In contrast, little evidence for changes of general physical or mental health in (expectant) fathers was found.

LIMITATIONS

Physical and mental health was assessed with a short questionnaire only (SF-12v2).

CONCLUSIONS

On average, women's mental health tends to improve before and after the birth of the first child. Men seem to be much less affected by the birth of a child than many previous studies suggest.

A Comparison of Functional Features of Chinese and US Mobile Apps for Pregnancy and Postnatal Care: A Systematic App Store Search and Content Analysis

BACKGROUND

Pregnancy to postpartum (PtP) applications (apps) are becoming more common tools to document everything from pregnancy and delivery to nutrient allocation, life taboos, and infant medical examinations. However, the dependability, quality, and efficacy of these apps remain unclear. This study examined the features and functions of mobile PtP care apps accessible in China and the United States and to identify the major gaps that need to be addressed.

METHODS

Apps were selected by searching the Apple App Store and Android Markets (in the US and China) for the terms "pregnancy" and "postpartum" in Chinese and English. The apps' security, quality, and effectiveness were investigated, and chi-square tests and analysis of variance were performed to examine the differences in characteristics between apps available in the US and China.

RESULTS

A total of 84 mobile PtP care apps (45 from the US and 39 from China) were included. A total of 89.7% (35/39) of Chinese mobile apps did not provide safety statements or supporting evidence. The objective app quality ratings for Chinese and US apps were 3.20 ± 0.48 (mean ± standard deviation) and 3.56 ± 0.45, respectively (p > 0.05). A greater number of Chinese apps provided app-based monitoring functions, namely recording fetal size (n = 18, 46.2% in China vs. n = 3, 6.7% in the US), contractions (n = 11, 28.2% in China vs. n = 0, 0% in the US), pregnancy weight (n = 11, 28.2% in China vs. 0, 0% in the US), and pregnancy check-up reminders (n = 10, 25.6% in China vs. n = 0, 0% in the US). Meanwhile, a greater number of US apps provided exercise modules, namely pregnancy yoga (n = 2, 5.1% in China vs. n = 21, 46.7% in the US), pregnancy workouts (n = 2, 5.1% in China vs. n = 13, 28.9% in the US), and pregnancy meditation (n = 0, 0% in China vs. 10, 22.2% in the US) (p < 0.01). A medium security risk was identified for 40% (18/45) of apps in the US and 82.1% (32/39) of apps in China (p < 0.01).

CONCLUSIONS

The functionality and characteristics of in-store mobile apps for PtP care varied between China and the US. Both countries' apps, particularly Chinese apps, encountered issues related to a lack of evidence-based information, acceptable content risk, and program evaluations. Both countries' apps lacked proper mental health care functions. The findings suggest that the design of app features should be enhanced in both countries, and increased interaction between app creators and users is recommended.

Perspectives of Women About Social Support Provided by Men During Pregnancy: A Qualitative Study

OBJECTIVES

Men have been regarded as critical partners in promoting maternal health and improving pregnancy outcomes, still men have not been able to provide these supports holistically during pregnancy due to the patriarchal nature of many Nigerian societies and dynamics in gender roles. There is a dearth of studies in Nigeria that have investigated the social support spouse provide during pregnancy. This study investigated the perspectives of women about the social support provided by men during pregnancy and factors that could influence or promote these support.

METHODS

Forty one consenting women who were purposively selected in six primary health centers that offer ANC services in Ibadan participated in the six focus group discussions; participants ranged from 6 to 8 in each group. Transcripts from audio recordings were analyzed using thematic analysis; similar and dissimilar themes within groups and across groups were categorized.

RESULTS

Discussants highlighted ways of providing social support mainly as assisting with household chores and taking care of other children. None of the discussants stated accompanying to antenatal clinic by their spouses as a way social support was provided during pregnancy. Almost all the women highlighted that social support provided by men changes as pregnancy advances but the changes were dependent on the number of children.

CONCLUSIONS

Community education and male friendly sessions are encouraged to promote men's participation and engagement during pregnancy.

Personality impacts fear of childbirth and subjective birth experiences: A prospective-longitudinal study

Background

Previous research suggests that less emotionally stable, less conscientious, less extraverted, and less agreeable women tend to suffer from higher fear of childbirth and experience their delivery as worse. Moreover, there is evidence that birth characteristics and unexpected incidents during delivery may impact women’s birth experiences. However, it remains unknown whether the role of personality in subjective birth experiences varies between women with different birth characteristics.

Methods

We used data from the Maternal Anxiety in Relation to Infant Development (MARI) Study, a regional-epidemiological study among pregnant women, who were prospectively followed up in multiple waves across the peripartum period. During pregnancy, personality was assessed with the short version of the Big Five Inventory. The Wijma Delivery Expectancy/ Experience Questionnaire was used to measure fear of childbirth (version A) during pregnancy and subjective birth experiences (version B) within the first 10 days after delivery.

Results

Linear regressions revealed that lower levels of emotional stability, agreeableness, and extraversion predicted higher fear of childbirth during pregnancy. Moreover, personality affected subjective birth experiences especially in women with specific birth characteristics: Lower emotional stability predicted worse subjective birth experiences in women with (vs. without) a preterm delivery, and higher conscientiousness predicted worse subjective birth experiences in women with an emergency cesarean section (vs. spontaneous delivery). Subjective birth experiences were also worse in less emotionally stable and less open women with (general) anesthesia (vs. no anesthesia) during delivery. Finally, higher emotional stability predicted a subjective birth experience that was worse than expected, particularly in multiparous women and women without anesthesia during delivery.

Conclusions

These findings suggest that less emotionally stable, less conscientious, and less open women tend to experience their delivery as worse particularly in case of unexpected incidents (i.e., preterm delivery, emergency cesarean section, and necessity of anesthetics) and might thus profit from early targeted interventions.

Personality and Peripartum Changes in Perceived Social Support: Findings From Two Prospective-Longitudinal Studies in (Expectant) Mothers and Fathers

OBJECTIVE

The aim of this study was to examine changes in perceived social support from early pregnancy to 2 years postpartum and to test whether these changes (a) differ between mothers and fathers or (b) vary as a function of the Big Five personality traits.

BACKGROUND

Higher peripartum social support in (expectant) mothers and fathers has been associated with fewer complications during pregnancy and delivery as well as better parental and offspring health.

METHODS

Prospective-longitudinal data from two regional-epidemiological samples from Germany were used: MARI (N = 396, including n = 293 mothers and n = 103 fathers) and DREAM (N = 2,819, including n = 1,689 mothers and n = 1,130 fathers). The Big Five personality traits were assessed during pregnancy in MARI as well as 8 weeks after the anticipated birth date in DREAM with short forms of the Big Five Inventory. Perceived social support was assessed during pregnancy, 4 months postpartum, and 16 months postpartum in MARI as well as during pregnancy, 14 months postpartum, and 2 years postpartum in DREAM using the short version of the Social Support Questionnaire.

RESULTS

Multilevel analyses revealed that perceived social support decreased across the peripartum period, and this decrease did not differ between mothers and fathers. More extraverted, emotionally stable, agreeable, conscientious, and open parents perceived higher levels of social support across the peripartum period. The peripartum decrease of perceived social support was smaller in parents who were more extraverted.

CONCLUSION

Our findings suggest that especially extraversion plays an important role for high and stable levels of perceived social support across the peripartum period.

IMPLICATIONS

Particularly highly introverted parents might profit from targeted social support interventions.