Journal of Reproductive and Infant Psychology最新文献

Aims/background: The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation.

Design/methods: We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported.

Results: We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings.

Conclusion: There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.

Background: COVID-19 pandemic characterised a unique and vulnerable social, emotional, and health environment for pregnancy, with potential long-lasting risks to maternal and child health outcomes. In women who were pregnant at the peak of COVID-19 pandemic, we investigated the association between pandemic-related concerns about pregnancy and delivery and both the parent's (i.e. maternal parenting stress) and the infant's (i.e. emotional-behavioral problems) outcomes 12 months after birth.

Methods: A sample of 352 Italian pregnant women completed a web-based survey from 8 April to 4 May 2020 and a follow-up at 12 months after delivery. Maternal assessment in pregnancy covered prenatal measures for: pandemic-related concerns about pregnancy and childbirth, COVID-19 stressful events exposure, pandemic psychological stress, and mental-health symptoms (i.e. depression, anxiety). The 12 months' assessment covered post-partum measures of social support, parenting stress and maternal reports of infants' behavioral problems.

Results: The results of the Quasi-Poisson regression models on the association between COVID-19 related influencing factors and parenting stress and infant's behavioral problems showed that the presence of higher pandemic-related concerns about pregnancy and childbirth scores was associated with greater total and internalising behavioral problems but not with parenting stress levels.

Conclusion: Perinatal mother-infant health has been sensitively threatened by pandemic consequences with maternal concerns about childbirth in pregnancy being associated with 12 months' children's behavioral outcomes. There is a need to invest in psychological support for perinatal women throughout the transition to parenthood to protect risk conditions before they get chronic or severe and influence offspring development.

Aims/background: Assessing the intensity of perinatal grief is very important for identifying the more complex cases in mothers and fathers. Despite this, there are few assessment tools available. The aim of this study was to analyse the psychometric properties (factorial structure, reliability, and validity) of the Spanish version of the Perinatal Grief Intensity Scale (PGIS).

Design/methods: An online survey was completed by 291 mothers and fathers who had suffered perinatal loss in the previous six years.

Results: The results showed adequate fit indexes for the three-factor model of the PGIS: reality, confront others, and congruence. Reliability values for the overall scale and subscales were adequate. Finally, with regard to validity, significant (p < .05) and positive relationships were found with levels of complicated grief, event centrality, guilt, anxiety, and depression. There were also differences depending on whether participants exhibited high or low levels of complicated grief, and on the number of weeks of pregnancy at the time of the loss.

Conclusion: In conclusion, the Spanish adaptation of the PGIS has adequate reliability and validity scores and a factorial structure consistent with the original version.

Aim: To evaluate the effectiveness of machine learning (ML) approaches in predicting individuals with postpartum depression (PPD), this study systematically reviewed and meta-analysed existing evidence.

Methods: A systematic search was conducted across five databases including Cochrane Library, PsycINFO, Embase, Medline and the China National Knowledge Infrastructure. The performance metrics of ML models were pooled and risk of publication bias was assessed. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.

Results: From an initial 4,994 identified articles, 10 studies involving a total of 9,189 participants met the inclusion criteria. The findings revealed high overall predictive performance: the pooled Area Under the Curve (AUC) was 0.889, pooled accuracy was 0.850 (95% CI: 0.800-0.899), pooled sensitivity was 0.706 (95% CI: 0.589-0.801), and pooled specificity was 0.886 (95% CI: 0.833-0.921). Significant heterogeneity was observed, with an I² value of 98.24% and a Q statistic of 513.03 (p < 0.001). The Deek's funnel-plot asymmetry test showed that there was no significant publication bias (p = 0.919). Subgroup analysis indicated higher sensitivity when diagnostic tools were used compared to screening tools.

Conclusions: This meta-analysis synthesised evidence on the prediction of PPD using ML approaches. Although ML models for PPD prediction exhibit high specificity, their limited sensitivity hinders overall predictive accuracy.

Background: Trans*, inter*, and non-binary (TIN*) individuals often face unique challenges in navigating societal, legal and institutional barriers to parenthood compared to cisgender sexual minority people. A prerequisite to adequately support this population is understanding their desire to become parents, expectations of barriers and concrete fertility intentions.

Aims: This study systematically investigates the parenthood desires and concrete fertility intentions among TIN* individuals compared to cisgender sexual minority people in Germany to deepen our understanding of TIN* desire for parenthood. This highlights heterogeneity within what is often summarised as one LGBTQI* community.

Design/methods: Using a large sample of 2,819 respondents, including 502 TIN* individuals, we examine differences in the desire for parenthood and the presence of concrete fertility plans among parents using binary logistic regression estimation.

Results: Our results show that TIN* individuals assigned female at birth are 62% less likely to desire parenthood compared to cisgender sexual minority women, while TIN* individuals assigned male at birth display similar parenthood desires to both cisgender sexual minority men and women. Further, TIN* individuals are less likely to have concrete fertility plans compared to cisgender sexual minority women. All respondent groups named legal and bureaucratic reasons most frequently as the main hurdles for fertility planning.

Conclusion: These findings highlight the complexity of family planning within the TIN* community and underline the importance of comprehensive care and support for LGBTQI* individuals navigating parenthood aspirations.

Background: Antenatal diagnoses of foetal abnormalities are associated with significant psychological distress for parents. This scoping review aims to identify and synthesise the existing literature on antenatally delivered psychological interventions for parents designed to support mental wellbeing following a foetal abnormality diagnosis.

Methods: A prospectively registered protocol guided this scoping review, utilising methodologies outlined by Arksey and O'Malley (2005) and Levac et al. (2010). A systematic search was conducted using five electronic databases (PsycINFO, CINAHL, Medline, SCOPUS and ProQuest) with no date limits, including studies up to June 2024. Data was extracted following the Template for Intervention Description and Replication (TIDieR) checklist and synthesised using narrative synthesis.

Results: Twelve articles were included, addressing congenital heart defects (n = 6), chromosomal disorders (n = 2), foetal surgical anomalies (n = 2), cleft lip (n = 1) and congenital abnormalities (n = 1). Interventions incorporated approaches such as cognitive behavioural therapy, acceptance and commitment therapy, mindfulness and counselling. Individual support was the predominant approach across studies. All interventions were hospital-based, delivered by healthcare professionals, including psychologists, nurses and cardiologists, with formats ranging from single sessions to multi-session programmes. Most targeted anxiety and depressive symptoms, while some addressed stress, emotional preparedness, and decision-making.

Conclusions: Antenatally delivered psychological interventions are emerging, but the evidence base remains limited. Future interventions should be tailored to meet individual needs, offer flexible delivery, and encourage multidisciplinary collaboration. Additionally, addressing both individual and systemic factors should be prioritised in the development of future interventions, as this may enhance feasibility, reach and impact.

Objective: This pilot study aims to investigate the preliminary feasibility and acceptability of a pre-emptive intervention for infants with a family history of autism and/or attention-deficit/hyperactivity disorder (ADHD) in Brazil.

Background: Infants with a first-degree relative diagnosed with autism or ADHD are more likely to meet diagnostic criteria for these conditions later in childhood. From the first year of life, these infants may also experience a range of developmental difficulties as well as differences in their day-to-day interactions with their caregivers. The pre-emptive iBASIS intervention has shown efficacy in enhancing caregiver-infant interaction and social-communication development in infants with family history or early signs of autism in the UK and Australia, but has not been assessed in lower-resource contexts nor for infants with a family history of ADHD.

Methods: iBASIS was delivered to nine Brazilian mothers of infants aged 4-13 months with and without a family history of autism/ADHD. Quantitative (number of drop-outs, number of sessions completed) and qualitative (themes developed from interviews with the mothers using reflexive thematic analysis) measures were used to assess feasibility and acceptability of iBASIS.

Results: Eight of the nine mothers completed all iBASIS sessions. Six mothers interviewed described receiving iBASIS as a positive experience with benefits for themselves and their infants consistent with the themes of the therapy. The mothers considered practical aspects of iBASIS to be feasible and challenges associated with completing the intervention surmountable.

Conclusions: These findings provide the first preliminary evidence of the good feasibility and acceptability of iBASIS in a non-English-speaking, socioeconomically and culturally diverse context.

Aims: To evaluate the effects of a mobile programme on infertility stress, anxiety, infertility self-efficacy, marital relationship, social support, and fertility quality of life in couples undergoing intrauterine insemination.

Methods: This quasi-experimental study was conducted over three weeks with a non-equivalent control group and a non-synchronised pre-test - post-test design. Fifty couples participated: 26 in the experimental group and 24 in the control group. The experimental group received a couple-based mobile programme, while the control group received conventional care. Data were analysed using descriptive statistics and the chi-squared, Fisher's exact, Wilcoxon rank-sum, Mann - Whitney U, and t-tests. Prior scores of the individual variables were controlled through an analysis of covariance, and the differences in the pre- and post-intervention mean values between the groups were compared. The main outcome measures were infertility stress, anxiety, infertility self-efficacy, marital relationship, social support, and fertility quality of life.

Results: The couple-based mobile programme effectively reduced infertility stress (F = 18.88, p < .001) and anxiety (F = 19.87, p < .001), and it improved infertility self-efficacy (F = 38.68, p < .001), marital relationship (F = 30.64, p < .001), and fertility quality of life (F = 21.08, p < .001).

Conclusion: The couple-based mobile programme can be used as an intervention to improve the quality of life for couples diagnosed with infertility who are undergoing intrauterine insemination. The results could form the basis for further development of interventions and strategies to improve the quality of life for couples considering ART.

Aims/background: The first 16 weeks postpartum pose exceptional challenges for new mothers and are associated with heightened emotional distress. Guilt and shame are particularly common in the postpartum period. Previous efforts to better understand how these emotions are defined and conceptualised among new mothers have not focused on a UK-specific population and have not captured experiences which are unique to the first sixteen weeks postpartum. This study aimed to address these research gaps.

Design/methods: Twenty participants self-selected to participate in a semi-structured interview at one time point. Participants were aged 25-35 (Mage = 30.71), and were mainly married (57.14%), primipara (71.43%), undergraduate educated or above (65%) and were in an [associate] professional occupation (60%). A content analysis was then applied to participant-generated definitions of guilt and shame.

Results: Guilt was identified as being a behaviourally tied moral emotion, while shame was identified as being a socially tied moral emotion. Four thematic clusters were identified from the content analysis: moral transgressions, pressure and judgement from others, inadequacy, and low mood and avoidance behaviour. The following recommendations are made in light of these findings: Address maladaptive public attitudes about help-seeking for psychological distress; prioritise funding allocation to parenting peer support community projects; and prioritise postpartum mental health training for healthcare practitioners in community settings. Several recommendations are discussed for research, as well.

Conclusion: This study generated broad parenting-specific definitions of guilt and shame and used a content analysis to understand, in greater depth, their conceptual overlaps and distinctions.

Background: The longstanding perception of women primarily as child bearers, alongside the importance placed on motherhood, has significantly shaped societal expectations. As an increasing number of women seek to overcome biological limitations in the pursuit of biological motherhood, surrogacy has emerged as a popular alternative for many couples. However, the lived experience of surrogacy can vary significantly due to the differing frameworks and regulations governing the process across countries.

Method: This qualitative study aimed to explore the subjective experiences of surrogacy through narrative-phenomenological interviews. Intended mothers (n = 4) and surrogate mothers (n = 4), were recruited via social media platforms. The data were analysed using interpretative phenomenological analysis.

Results: Both intended and surrogate mothers generally express gratitude for their experiences with surrogacy. However, both parties acknowledge that surrogacy is not a suitable option for everyone and emphasise the importance of evaluating personal boundaries and expectations beforehand. Intended mothers are motivated by the aspiration for a genetic link, while surrogate mothers are primarily driven by a desire to help others and by financial compensation. The trust between the involved parties was the most critical aspect shaping the participants' lived experiences.

Conclusion: The findings highlight trust as a fundamental component influencing the relational dynamics and overall experiences of both intended and surrogate mothers throughout the surrogacy journey. Trust fosters a sense of security, which is essential for navigating the complexities of surrogacy.