Journal of Reproductive and Infant Psychology最新文献

Background: India's rising dependence on institutional childbirth through Caesarean sections has intensified both the health-related risks and the financial pressures experienced by women and their households. The escalating costs of Caesarean deliveries have become a significant source of out-of-pocket spending, with the burden falling most heavily on low-income families in Kerala.

Objective: This study aims to identify the cognitive, emotional, and healthcare related predictors that influence women's intentions to opt for elective Caesarean delivery. It seeks to understand the underlying factors that shape this preference, using the theory of planned behavior framework, which emphasizes the role of attitudes, subjective norms, and perceived behavioral control in shaping behavioral intentions.

Methods: Using a cross-sectional design, a structured household survey was conducted among 1,030 married women in Kerala planning future pregnancies. The main outcome measured was their stated intention to opt for a Caesarean delivery in a subsequent birth. Key predictors included unmet health needs, childbirth-related knowledge, depression severity, attitudes, subjective norms, and perceived behavioral control. Binary logistic regression and propensity score matching (STATA 14.0; p < 0.05) were applied to identify statistically significant associations.

Results: Greater childbirth-related knowledge significantly lowered the likelihood of intending to choose a Caesarean delivery (intermediate knowledge: OR = 0.167; good knowledge: OR = 0.297). Depression severity displayed a nonlinear relationship: moderately severe depression reduced the intention to opt for a C-section (OR = 0.140), whereas severe depression substantially increased it (OR = 4.357). The most influential predictor was unmet healthcare need (OR = 27.876), a result further supported by propensity score matching.

Conclusion: Women's intentions to choose elective Caesarean delivery are strongly influenced by their level of knowledge, psychological well-being, and access to healthcare. Strategies that strengthen health literacy, bolster mental health support, and reduce healthcare barriers may help decrease unnecessary C-sections and enhance maternal health outcomes.

Aims/background: Breaking the cycle of infertility through assisted reproductive technology (ART) can be burdensome for couples, potentially impacting the family. Our study investigated long-term effects of infertility and ART stress on families by comparing families formed through ART with those formed through natural conception (NC).

Design/methods: Two-child families (children aged 1-14), with the first-born conceived through ART (ART-1; n = 47), the second-born conceived through ART (ART-2; n = 19), or both children conceived naturally (NC; n = 52), were assessed. Parents completed questionnaires on stress, mental health, and parenting. Fingernail and saliva samples were collected to assess salivary cortisol awakening response (CAR), fingernail cortisol, and cortisone.

Results: Infertility and ART were retrospectively described as highly stressful, varying by sex, parity, and protractedness of procedure. After successful ART, most parents no longer felt burdened by infertility and treatment, aligning with NC parents regarding stress and mental health. Yet, ART parents appeared more involved in parenthood, including greater importance of motherhood, maternal family-work conflict, and parental overprotection. ART mothers and their children had higher fingernail cortisol and cortisone than NC mothers and their children. No group differences were observed in the CAR. Past infertility and ART stress correlated with parenting and maternal chronic stress.

Conclusion: Successful ART can bring subjective relief. However, the experience of infertility and ART may manifest as high involvement in parenthood, especially among mothers, and contribute to psychobiological stress in ART mothers and their children. Longitudinal research and targeted psychological support should promote family functioning after ART.

Aim: This study aimed to determine the prevalence of excessive crying (EC) in Japanese infants and determine whether EC at two months postpartum is associated with mother-infant bonding at five months postpartum.

Methods: The participants were mothers aged 18 years or older who were hospitalised after the delivery of a full-term, singleton baby. They were recruited during their postpartum stay at a university hospital and were surveyed at two and five months postpartum using online questionnaires. The collected data were analysed using bivariate and multiple logistic regression analyses.

Results: A total of 142 mothers agreed to participate and provided written informed consent; among them, 108 and 107 responded to the survey at two and five months postpartum, respectively. The prevalence of EC among the participants was 15.7% and 6.5% at two and five months of age, respectively. Multiple logistic regression showed that EC at two months and the Edinburgh Postnatal Depression Scale score at five months postpartum were associated with mother-infant bonding at five months postpartum (adjusted odds ratio [AOR]: 8.72, 95% confidence interval [CI]: 1.10-69.29; AOR: 1.49, 95% CI: 1.19-1.87, respectively).

Conclusion: This study is the first to show that EC at two months was associated with mother-infant bonding at five months postpartum. Mothers of infants exhibiting EC need continuous support, even after EC subsides.

Background: This study aimed to examine the effects of education and counselling provided to mothers of six-month-old infants during the transition to complementary feeding on complementary feeding behaviours and parenting self-efficacy.

Methods: This randomised controlled study was conducted between December 2023 and February 2024. The sample comprised 608 mothers with six-month-old infants (Education + Counselling group n = 305, Counselling group n = 303). The study results focused on the mothers' behaviours related to complementary feeding and parenting self-efficacy The data were analysed using the Statistical Package for the Social Sciences (SPSS) Version 26.0.

Results: In the Education + Counselling group, the mothers' average age was 27.43 ± 3.94 years, whereas in the Counselling group, the average age was 27.59 ± 3.91 years. There were no significant differences in sociodemographic scores between the groups. After the four-week intervention, the Complementary Feeding Behaviour Scale (CFBS) score of the Education + Counselling group (101.22 ± 10.31) was found to be significantly higher than that of the Counselling group (97.81 ± 9.79). Additionally, the parenting self-efficacy scores of the Education + Counselling group (79.18 ± 6.99) were significantly higher than those of the Counselling group (64.23 ± 14.97).

Conclusion: The education provided to mothers positively influenced their complementary feeding behaviours and increased their parenting self-efficacy. Recommendations include the development of health policies and initiatives to support healthy feeding behaviours. Online training given to mothers can be used to support complementary feeding behaviours.

Background: Dissatisfaction with childbirth is a known risk factor for childbirth-related PTSD, which in turn can impair postpartum bonding. Personality traits may help explain why some women develop childbirth-related PTSD symptoms or maintain better bonding despite similar birth experiences. This study examined the role of personality traits in the associations between birth satisfaction, childbirth-related PTSD symptoms, and postpartum bonding.

Methods: The sample consisted of 391 Lithuanian women who had given birth 4 to 12 weeks before participating in the study. Measures included the City Birth Trauma Scale, Birth Satisfaction Scale, Postpartum Bonding Questionnaire, and Big Five Inventory.

Results: Moderated mediation analysis showed that lower birth satisfaction was linked to more childbirth-related PTSD symptoms, which, in turn, were associated with poorer bonding. This indirect association was weaker among women higher in conscientiousness and stronger among those higher in neuroticism. Extraversion and agreeableness showed marginally significant moderating effects: extraversion slightly weakened the association between birth satisfaction and childbirth-related PTSD symptoms, while agreeableness slightly reduced the relationship between higher PTSD symptoms and impaired postpartum bonding. Openness did not moderate either path.

Conclusions: Personality traits can help explain individual differences in how birth satisfaction relates to childbirth-related PTSD symptoms and postpartum bonding. Agreeableness and conscientiousness can serve as protective factors, while neuroticism can increase vulnerability to these symptoms and their association with bonding difficulties. These findings highlight the importance of considering personality in perinatal mental health care, as personality traits may shape psychological responses to childbirth and their implications for mother-infant bonding.

Objective: To synthesise qualitative studies on perinatal women's mental health screening preferences to guide the timely creation of interventions and the delivery of individualised screening by healthcare professionals.

Methods: A meta-synthesis of Chinese and English datasets was conducted till 30 November 2024. The methodological quality was assessed using the JBI criteria.

Results: Through meta-synthesis of the 13 included publications, we identified four key integrative findings: (1) mental health screening experiences, (2) preferences for screening implementation, (3) barriers to effective screening, and (4) proposed strategies for optimisation. These findings were further categorised into 11 distinct thematic groups.

Conclusion: This study synthesises perinatal women's preferences, experiences, and barriers regarding mental health screening, highlighting the need for diversified screening modalities and address multi-level obstacles. Future efforts should focus on developing evidence-based and personalised screening strategies to enhance screening uptake and effectiveness.

Aims: The goal of this study was to understand perinatal care professionals' perceptions of perinatal mental health screening and determinants of equitable screening implementation.

Methods: Study participants were perinatal care professionals (n = 24), including obstetricians/gynaecologists, midwives, doulas, and other healthcare providers. Eligibility criteria required participants to either provide care to patients in the United States insured through Medicaid or other public insurance programs or work in practices serving individuals facing socioeconomic challenges. We conducted semi-structured interviews to explore participants' experiences with screening for perinatal mental health. Thematic analysis was employed to identify emergent themes related to the determinants of screening implementation, with the Health Equity Implementation Framework (HEIF) serving as the organising structure.

Results: Perinatal care professionals perceived screening results to facilitate discussion, awareness of mental health, and clinical decision-making. They identified several determinants influencing equitable implementation through impacting perceived screening validity, completion, patient experience, follow-up, and clinical workflows. Determinants aligned with the HEIF and included characteristics of the (1) screening (e.g. modality, frequency, type of tool), (2) perinatal individual, (3) perinatal care professionals, (4) clinical encounter, (5) other individuals involved before or after screening, and (6) context.

Conclusion: Perinatal care professionals view screening as an important element of clinical decision-making. Reducing inequities in detecting perinatal mood and anxiety disorders requires offering screenings in patients' preferred languages, improving patient-provider relationships, and training to implement best practices. Future research should examine variations in screening implementation to ensure equitable detection of perinatal mood and anxiety disorders.

Aims: Postpartum depression is the most common complication after giving birth, affecting 5-26% of mothers. Despite recommendations for perinatal screening, it remains underdiagnosed. Diverse psychological interventions have demonstrated to be effective for depressive symptoms during the perinatal period, and Brief Dynamic Psychotherapy (BDP) working on maternal representations has shown promising results. Clinical guidelines have started to prioritise preventive psychological interventions. This study assesses the efficacy of a brief dynamic, online psychological intervention aimed at preventing postpartum depression, anxiety, and bonding difficulties in women identified to be at risk.

Methods: The study is a randomised controlled trial (RCT) with repeated measures, including an initial assessment and follow-ups at 3 and 9 months postpartum. Of the 125 women screened, 65 met at least one risk criterion: current depressive or anxious symptoms, a history of depression, a stressful life event in the past year, or low perceived social support. The final sample included a control group (N = 32), which received standard community pregnancy care (TAU), and a intervention group (N = 33), which received TAU and four sessions of BDP. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS), anxiety was assessed with the State-Trait Anxiety Inventory (STAI) and Postpartum Bonding Questionnaire (PBQ) was used to evaluate bonding with the infant.

Results: The intervention led to sustained reductions in depressive symptoms and improvements in anxiety, with suggestive results on mother - infant bonding.

Conclusion: This trial supports research on PPD prevention, highlighting BDP as a preventive complement to standard care for at-risk women.

Background: Gravidity is a factor that contributes to the risk of mental health problems during pregnancy. Prevention occurring before pregnancy could reduce the risk of long-term adverse effects in mothers and children. However, knowledge about the associations between gravidity and mental health during the pregnancy planning phase is scarce.

Methods: This study used cross-sectional data from the preconception phase of the PREGO Study. A total of 617 female participants (417 nulligravid, 200 primigravid/multigravid) were included and multivariable regression analyses were used to examine associations between gravidity status (primi/multigravid vs. nulligravid) and symptoms of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), stress (Perceived Stress Scale), and psychological distress (Kessler Psychological Distress Scale), adjusting for age, family income, education level, ethnic and cultural origins, body mass index, and alcohol consumption.

Results: The primi/multigravid group was associated with higher levels of depressive symptoms and distress before and after adjusting for confounding factors (adjusted B = 0.93, 95% CI [0.38-1.47] and adjusted B = 0.61, 95% CI [0.02-1.21], respectively). No statistically significant associations between gravidity and symptoms of anxiety and stress were observed.

Conclusion: Individuals who have previously been pregnant may have higher levels of depressive symptoms and distress when planning a subsequent pregnancy than those with no prior experience of pregnancy. An awareness of these findings in preconception groups could help improve pregnancy and postpartum mental health outcomes.