Antenatal Psychobiological Predictors of Psychological Response to Childbirth

Alder, Judith; Breitinger, Gertrud; Granado, Cristina; Fornaro, Isabel; Bitzer, Johannes; Hösli, Irène; Urech, Corinne

doi:10.1177/1078390311426454

Cited by 26 publications

(16 citation statements)

References 35 publications

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“…This result suggests that the disruption on this cortisol basal rhythm [ 73 ] consequence of the elevated cortisol levels by bedtime may be related with the dynamic of the awakening response. Indeed, previous research has documented the association between the CAR and psychological outcomes, such as anxiety, depression or work stress [ 14 , 31 , 41 , 42 , 80 ] or during pregnancy, as related with fear regarding the anticipation of childbirth [ 2 ]. Therefore, CAR is very likely to be sensitive to chronic stress and its anticipation [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Adult attachment style and cortisol responses in women in late pregnancy

Costa-Martins¹,

Moura‐Ramos

Cascais³

et al. 2016

BMC Psychol

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BackgroundRecent research has documented the association between attachment and cortisol rhythms. During pregnancy, when attachment patterns are likely to be activated, elevated levels of cortisol are associated with negative effects for the mother and the foetus. The aim of the present study was to examine the association of adult attachment style and cortisol rhythms in pregnant women.MethodsEighty women in the third trimester of pregnancy participated in the study. Adult attachment was assessed using the Adult Attachment Scale – Revised (AAS-R). Participants collected 4 samples of salivary cortisol at two different days; 3 samples were collected in the morning immediately after wakeup and one sample was collected by bedtime.ResultsResults found group significant differences in the cortisol diurnal oscillation (F(1,71) = 26.46, p < .001,), with secure women reporting a steep decrease in cortisol from awakening to bedtime, while women with fearful avoidant attachment reported no changes. No group differences were found regarding the cortisol awakening response.ConclusionsThese results highlight the importance of considering attachment patterns during pregnancy, suggesting fearful avoidant attachment style as a possible risk factor for emotional difficulties and dysregulation of the neuroendocrine rhythms.

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Section: Discussionmentioning

confidence: 99%

Adult attachment style and cortisol responses in women in late pregnancy

Costa-Martins¹,

Moura‐Ramos

Cascais³

et al. 2016

BMC Psychol

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“…Untreated antenatal depression can be associated with risk of postpartum depression, which has significant consequences for the health and well-being of the infant [ 2 ]. Antenatal depression is a public health concern due to its negative effect on the general health of the woman and its association with underutilization of antenatal care services, complications during pregnancy, negative experience of childbirth, adverse pregnancy outcomes (e.g., preterm birth, low birth weight, still birth, and birth asphyxia), and infant mortality and morbidity (i.e., poor infant growth and development) [ 3 – 7 ]. Moreover, the magnitude of the impact of antenatal depression varies across socioeconomic status [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study

et al. 2015

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BackgroundPsychosocial health problems, specifically depression during pregnancy, can have negative impact on birth outcomes, postnatal mental health of the mother, and infant health. Antenatal depression is more prevalent among women in low- and middle-income countries than among women in high-income countries. Risk factors for antenatal depression reported in the literature relate to pregnant women in South Asia. Consequently, this study assessed depression in pregnancy and related psychosocial risk factors among select pregnant women residing in Mwanza region, Northern Tanzania.MethodsWe analysed data from 397 pregnant women recruited from three antenatal clinics for the period June—August 2013 for this cross-sectional study. Women provided data at one time point during their pregnancy by completing the Edinburgh Postnatal Depression Scale and a structured questionnaire assessing psychosocial, demographic, and behavioural risk factors related to antenatal depression. Multiple logistic regression analysis was performed to determine the relationship between risk factors examined and antenatal depression.ResultsOverall, 33.8 % (n = 134) of pregnant women had antenatal depression. Pregnancy-related anxiety was associated with antenatal depression (odds ratio (OR) 1.36, 95 % confidence interval (CI) 1.23 to 1.5). Pregnant women with poor relationship with partner and low/moderate socio-economic status had the highest OR for antenatal depression (82.34, 95 % CI 4.47, 1516.60) after adjusting for other covariates. Pregnant women with poor relationship with partner and high socio-economic status had an OR of 13.48 (95 % CI 1.71, 106.31) for antenatal depression. “Reference” pregnant women were those with very good relationship with partner and high socio-economic status.ConclusionsHigh proportion of self-reported depression among select pregnant women attending antenatal clinics in Mwanza, Tanzania merit integrating depression assessment into existing antenatal care services. Health care providers need to assess pregnancy-related risk factors (pregnancy-related anxiety), socio-demographic factors (socio-economic status), and interpersonal risk factors (relationship with partner). Future research should appraise effectiveness of interventions that enhance partner relationships in reducing antenatal depression across all wealth distributions.

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“…Studies have shown that FoC negatively affects women in a number of ways, including sleep disturbance and depression in pregnancy [13], increased health care use during the perinatal period [14], requests for medical interventions such as an elective caesarean section, a priori request of epidural analgesia without pain experience [15–18], negative experience of childbirth, postpartum depression, post-birth trauma [19–21], and low rates of breastfeeding [22, 23]. Negative effects of FoC are also associated with increased incidence of small gestational age (15 %), increased preterm birth rate (12 %), infant admission to intensive care [24, 25] as well as poor quality of infant’s sleep [26].…”

Section: Introductionmentioning

confidence: 99%

‘I’ve Changed My Mind’, Mindfulness-Based Childbirth and Parenting (MBCP) for pregnant women with a high level of fear of childbirth and their partners: study protocol of the quasi-experimental controlled trial

et al. 2016

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BackgroundApproximately 25 % of pregnant women suffer from a high level of Fear of Childbirth (FoC), as assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A, score ≥66). FoC negatively affects pregnant women’s mental health and adaptation to the perinatal period. Mindfulness-Based Childbirth and Parenting (MBCP) seems to be potentially effective in decreasing pregnancy-related anxiety and stress. We propose a theoretical model of Avoidance and Participation in Pregnancy, Birth and the Postpartum Period in order to explore FoC and to evaluate the underlying mechanisms of change of MBCP.Methods/DesignThe ‘I’ve Changed My Mind’ study is a quasi-experimental controlled trial among 128 pregnant women (week 16–26) with a high level of FoC, and their partners. Women will be allocated to MBCP (intervention group) or to Fear of Childbirth Consultation (FoCC; comparison group). Primary outcomes are FoC, labour pain, and willingness to accept obstetrical interventions. Secondary outcomes are anxiety, depression, general stress, parental stress, quality of life, sleep quality, fatigue, satisfaction with childbirth, birth outcome, breastfeeding self-efficacy and cost-effectiveness. The total study duration for women is six months with four assessment waves: pre- and post-intervention, following the birth and closing the maternity leave period.DiscussionGiven the high prevalence and severe negative impact of FoC this study can be of major importance if statistically and clinically meaningful benefits are found. Among the strengths of this study are the clinical-based experimental design, the extensive cognitive-emotional and behavioural measurements in pregnant women and their partners during the entire perinatal period, and the representativeness of study sample as well as generalizability of the study’s results. The complex and innovative measurements of FoC in this study are an important strength in clinical research on FoC not only in pregnant women but also in their partners.Trial registrationDutch Trial Register (NTR): NTR4302, registration date the 3rd of December 2013.

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Antenatal Psychobiological Predictors of Psychological Response to Childbirth

Abstract: The associations found in this study can improve identification during pregnancy of women at risk for negative psychological response to childbirth. For these women, the provision of supportive care during pregnancy should be evaluated.

Cited by 26 publications

References 35 publications

Adult attachment style and cortisol responses in women in late pregnancy

Adult attachment style and cortisol responses in women in late pregnancy

Antenatal depression is associated with pregnancy-related anxiety, partner relations, and wealth in women in Northern Tanzania: a cross-sectional study

‘I’ve Changed My Mind’, Mindfulness-Based Childbirth and Parenting (MBCP) for pregnant women with a high level of fear of childbirth and their partners: study protocol of the quasi-experimental controlled trial

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