Journal of Reproductive and Infant Psychology最新文献

Aim/background: Surrogacy as an assisted reproductive technology is a female story in which an infertile woman rents a fertile woman's womb to carry her child. Many researches have focused on the surrogates' experiences and well-being and the literature is limited on the experiences of the intended mothers. The aim of this study was to reflect on the sufferings of the infertile women who are labelled as intended mothers in surrogacy.

Design/method: Semi-structured interviews were conducted with intended mothers who were either in the surrogacy process or who had a child. Questions were centred around the intended mothers' experiences throughout surrogacy process. Interview were analysed using Reflective Lifeworld Research.

Results: The result of the analysis reveals seven themes: 1) physical harms, 2) emotional and mental consequences, 3) social pressure, 4) economic consequences, 5) trust issues, 6) surrogacy mask, 7) life crisis.

Conclusion: Findings suggest that the intended mothers need to receive more psychological and emotional support from the society and healthcare system and economic support from the policy makers.

Objectives: This study aimed to examine the relationship between pregnancy-specific stress and parenting stress across the perinatal period, as well as the potential for moderation by perceived social support among low-income and diverse mothers.

Background: Stress during pregnancy is a common occurrence that is associated with adverse maternal and child health outcomes. Understanding the ways in which stress during pregnancy matters for postnatal stress, as well as protective factors that buffer the negative consequences of stress during pregnancy, are critical for the development of effective interventions.

Methods: Using a clinic-based sample of women who were recruited at their first prenatal appointment and participated in five online surveys (three prenatal and two post-birth surveys) (n = 124), we used multiple regression analysis to examine the associations between pregnancy-specific stress measured in the third trimester and parenting stress measured at 2 months postpartum, as well as the moderating role of perceived social support measured during the second trimester.

Results: Pregnancy-specific stress was associated with higher postpartum parenting stress and perceived social support was associated with lower parenting stress. In addition, social support attenuated parenting stress among women with low levels of pregnancy-specific stress, but not high levels.

Conclusion: Social support can be a useful tool to reduce parenting stress for those with lower levels of pregnancy stress. Future research should investigate reasons for high pregnancy-specific stress and the mechanisms leading to postpartum parenting stress to better understand and prevent adverse maternal and child outcomes.

Background: Perinatal mental health is fundamental to a healthy society. The aim of this study was to describe the trajectories of women's posttraumatic stress disorder (PTSD) symptoms during the perinatal period to assess their association with child behaviour problems at 12 months.

Methods: We designed an observational longitudinal study. Women were recruited through social media posting during the Coronavirus Disease 2019 (COVID-19) pandemic Italian national lockdown from 8 April to 4 May 2020, and contacted again at 6 and 12 months after the expected delivery date, collecting PTSD scores each time. Behavioural outcome of the children were measured at 12 months postpartum. Inclusion criteria were residence in Italy, age over 18 years, and fluency in Italian.

Results: A total of 327 mother-child dyads were eligible for inclusion in the study. Cluster analysis suggested five groups of maternal PTSD trajectories: a very low and stable (VL) group, 2 groups with decreasing PTSD symptoms over time (one high and decreasing (H-), one low and decreasing (L-)), and 2 groups with worsening PTSD symptom trajectories (one high and increasing (H+), one low and increasing (L+)). The H+ and H- clusters had significantly higher risks (+58% and + 76% for H+ and H-, respectively) of total child behavioural problems compared with the VL cluster, higher for internalising problems.

Conclusions: Although many women had PTSD scores below the cut-off, children of mothers with elevated prenatal symptoms remain at significant risk of behavioural problems. Longitudinal modelling of perinatal PTSD symptoms is warranted for sensitive two-generation risk detection.

Aims: This longitudinal study examines how coparenting experiences in the family of origin influence family alliance in lesbian and gay parent families formed via assisted reproduction, and whether internalised parenthood-related stigma moderates these associations.

Methods: Using a longitudinal, multi-method design, 38 lesbian mother families through donor insemination and 36 gay father families through surrogacy were recruited, all with children (52.70% assigned female at birth) aged approximately 36 months at time 1 (T1) and 48 months at time 2 (T2), residing in Italy. At T1, parents reported family-of-origin coparenting experiences and internalised stigma through interviews. At T2, family alliance was assessed using the Lausanne Trilogue Play during triadic interactions. Linear regression models tested direct and moderated effects.

Results: Most lesbian and gay parent families demonstrated cooperative family alliances. Parents reporting more conflictual and less supportive family-of-origin coparenting at T1 showed poorer family alliances at T2. Internalised stigma moderated this association, with higher stigma levels intensifying the negative effects of conflictual family-of-origin coparenting experiences on current family alliance.

Conclusion: The findings highlight the impact of early family experiences and minority stress on family alliance in lesbian and gay parent families formed via assisted reproduction. Parenting interventions with these families should address unresolved family-of-origin issues and support parents in mitigating internalised stigma to promote cooperative family alliances. Advocacy efforts are essential to reduce stigma and promote inclusive policies for diverse families.

Background: Paediatric obesity is a global public health issue. Prenatal maternal mental health is potentially implicated in the development of childhood obesity. This study examined associations between prenatal maternal cortisol, self-reported stress, anxiety and depression in the second trimester, and childhood overweight and obesity at 5 years of age.

Methods: A nested case-control study was conducted using data from the Irish prospective longitudinal birth cohort SCOPE BASELINE. Cases were children with overweight or obesity, operationalised as having a BMI z-score above +2 standard deviations. Controls were children with a BMI z-score between -0.5 and 0.5 standard deviations at 5 years of age. Two to one matching by sex was conducted. Thirty-eight cases and 83 sex-matched controls were included. Maternal serum cortisol concentration and self-reported stress, anxiety and depression were measured at 15 ± 1 and 20 ± 1 weeks gestation. Conditional logistic regression analyses were conducted to examine associations between prenatal maternal cortisol and self-reported stress, anxiety and depression, and childhood overweight and obesity.

Results: Despite some evidence for associations between anxiety and depression, and child BMI z-scores in univariate analyses, adjusted models indicated no associations between prenatal maternal stress (OR: 1.02, 95% CI: 0.94-1.12), anxiety (OR: 1.03, 95% CI: 0.97-1.09), depression (OR: 1.04, 95% CI: 0.91-1.19), or cortisol concentration (OR: 0.99, 95% CI: 0.99-1.00) and child BMI z-score.

Conclusion: Our findings do not provide support for associations between foetal exposure during the second trimester of pregnancy and maternal cortisol, stress and anxiety, and childhood overweight or obesity at 5 years of age.

Aims: To determine what kinds of birth-related experiences of success and failure are described by the participants, and whether there are differences according to fear of childbirth and parity. Studying these experiences is important for understanding the psychological mechanisms behind different childbirth experiences and their impact on maternal mental well-being.

Methods: This was a longitudinal mixed methods study. Descriptions of the birth experiences of 113 Finnish participants were gathered in a survey at 4-8 weeks postpartum and analysed with content analysis. Fear of childbirth was determined antenatally with the Wijma Delivery Expectations scale (W-DEQ A).The number of success and failure expressions were compared between people with FOC and others and between primiparous and multiparous people.

Results: The contents of the childbirth-related experiences of success and failure were categorised into 12 subcategories, organised under three higher-order categories that were named personal factors, course of childbirth, and support. The most typical expressions of success were in the categories of mode of birth, staff, and mental factors, and the most typical expressions of failure in the categories of staff and mental factors. Experiences of failure were more often expressed by primiparous than multiparous people, but there were no statistically significant differences by FOC. Expressions of success were equally common regardless of parity or FOC.

Conclusion: Postpartum people categorise aspects of their birth experiences in terms of success and failure. Primiparous people are more susceptible to experiencing failure at childbirth, but possible differences between people with FOC and other people warrant further investigation.

Aims/background: Studies on the association between perineal trauma (episiotomy and tear) and the risk of postpartum depression in Omani mothers are scarce. This study aimed to screen women for the risk of postpartum depression and associated maternal adverse outcomes (episiotomy and tear) in newly delivered Omani mothers.

Design/methods: Mothers were screened for postpartum depression using only the Edinburgh Postnatal Depression Scale (EPDS), with cut-offs of 1-12 indicating low risk and 13-30 indicating high risk. Data on birth outcomes were collected retrospectively from the medical records. Descriptive analyses, group comparisons, and linear regression analyses were conducted.

Results: Of the 262 participating mothers (total sample, i.e. mothers with and without depression), 19.0% had an episiotomy, 29.0% had tears, and 52.0% had an intact perineum after their childbirth. The total EPDS score was significantly higher among mothers with episiotomy (10.4, SD = 5.4) compared to those with tears (8.1, SD = 4.8) and those with intact perineum (9.4, SD = 4.9) (p-value <0.05). Lower levels of depression (-2.23 points on average) were significantly (p-value <0.05) associated with higher levels of perineum status (coded as 1 = episiotomy, 2 = other). Mothers who had a tear or episiotomy had on average 1.24 points higher EPDS scores compared to mothers with an intact perineum, although not significant (p-value >0.05).

Conclusions: Policymakers and clinicians are recommended to consider following up mothers with adverse birth outcomes to outline the risk of developing postpartum depression, at the same time as they routinely screen all mothers for risk of postpartum depression during their postpartum visits.

Background: Even though in many countries suicide is the leading cause of maternal deaths during the postpartum period, the prevalence of thoughts of self-harm (SHTs), an important risk factor for suicide attempts, is still not well documented.

Aim: We aimed to investigate the prevalence of SHTs in a Polish cohort of postpartum women and identify socio-demographic and maternal mental health factors associated with experiencing SHTs.

Method: 1545 women took part in a midwife-led postpartum depression (PPD) screening. 337 of them reported SHTs. The Edinburgh Postpartum Depression Scale (EPDS) was administered. Specifically, we used an abbreviated 5-item version to assess depression symptoms, item 10 to assess SHTs, a composite score of items 1 and 2 - anhedonia, and a composite score of items 3, 4, and 5 - anxiety. Logistic regression analyses were performed to examine associations between variables.

Results: Approximately 2% (n = 337) of women self-reported experiencingSHTs. Within the group of postpartum mothers who self-reported SHTs, 65.60% (n = 221) manifested the symptoms of PPD, and 56.40% (n = 190) - of anxiety. The symptoms of PPD, a mood disorder diagnosed in the past, and younger age were predictors of SHTs.

Conclusion: The results of this study can contribute to the development of prevention strategies: analysing separately items from PPD screening questionnaires focusing on SHTs can be an important part of prevention. The lack of the symptoms of PPD and anxiety risk does notexclude experiencing SHTs.

Background: Anxiety in the peripartum period (pregnancy through one-year postpartum) has negative impacts on mothers and infants. During the COVID-19 pandemic, high rates of anxiety were reported worldwide, but trajectories for how these symptoms change longitudinally in the peripartum period remain unknown.

Methods: A total of 1,411 women who were pregnant during the second U.S. COVID-19 surge completed four study questionnaires between December 2020 and March 2022, including assessments of anxiety symptoms (GAD-7) and individual and community-level contributors. Latent Class Growth Mixture Models (LCGMM) were used to identify anxiety trajectories, and multinomial logistic regression was used to identify contributors to class membership.

Results: Three classes of anxiety symptom trajectories were identified. Class 1 (n = 956, 67.8%) experienced minimal/mild anxiety throughout the peripartum period. Class 2 (n = 362, 25.7%) experienced initial moderate anxiety that remained stable. Class 3 (n = 93, 6.6%) experienced initial moderate anxiety that increased to severe in the postpartum period. Stress and history of mental health diagnosis contributed to higher initial levels of anxiety and ongoing social support contributed to lower levels of anxiety. In addition, financial insecurity increased the risk of belonging to Class 3.

Conclusions: Screening for anxiety symptoms and psychosocial vulnerabilities in the peripartum period is vital, as is early intervention. This is especially the case among women with limited financial and social resources who may experience chronic or worsening anxiety as they transition to parenthood.

Introduction: The COVID-19 pandemic resulted in a partial lockdown in Malaysia known as Movement-Controlled-Order (MCO), which has affected primary care management and social life norms. Thus, psychological health is a concern for mothers, particularly during the postpartum period. This study aimed to determine factors associated with maternal emotional experiences and coping during the pandemic.

Methodology: Mothers of infants aged < 18 months (n = 1449) in Malaysia completed an online survey during MCO (July 2020 to February 2021). The survey comprised questions on sociodemographics, pandemic livelihood impact, maternal experiences, and emotions.

Results: More than one-third of mothers expressed feeling worried (54.7%), annoyed (48.1%), and tired (42.2%) to some or a high extent. Mothers who were younger (p = .001), more educated (p = .001), faced difficulty paying rent (p = .002), and whose husbands were unemployed (p < .001) expressed higher negative emotions. In contrast, mothers who received enough support for health (p = .001) and breastfeeding (p = .008), had infants sleep less (p = .042) and had more time to focus on health (p < .001) expressed better emotions. Higher coping was expressed among mothers with a higher household income (p = .004), had more time to focus on their health (p = .010), received additional breastfeeding support (p = 0.039), and practised traditional postpartum care (p < .001). In contrast, difficulty paying for essentials (p = .023) was associated with negative coping.

Conclusion: Maternal emotional experiences were significantly associated with sociodemographic characteristics, livelihood impact, postnatal experiences, and infant behaviours. Postpartum mental health screening is recommended to prevent severe distress, especially in first-time mothers. Coping interventions for mothers at risk may include comprehensive support and maternity care.