Maternal adjustment and infant outcome in medically defined high-risk pregnancy.

Abstract

Biological and psychosocial risk factors in high-risk pregnancy and their relation to infant developmental outcomes were explored in a sample of 153 pregnant Israeli women who had pregestational diabetes mellitus, gestational diabetes mellitus, or were nondiabetic. Questionnaires on coping and resources as well as well-being and distress during the 2nd trimester were administered. Estimates of maternal fuels (HbAlc and fructosamine) were obtained throughout pregnancy. At 1 year, offspring were administered the Bayley Scales of Infant Development and mother-infant interactions were observed. Infants of mothers in the diabetic groups scored lower on the Bayley Scales and revealed fewer positive and more negative behaviors than did infants of mothers in the nondiabetic group. Infant outcomes in the maternal diabetic groups were associated with maternal metabolism. Maternal coping and resources differed in the 3 groups and differentially predicted infant development.

Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review

“…The majority of studies were conducted in Sweden [22,25-27,34] and the USA [31,33,35-38], and the remaining studies were conducted in Australia [28], Greece [30], Israel [32], Italy [29], and the UK [19,23]. The focus of nine studies was the pregnancy itself [25,26,30-33,35,36,38], while three focused on the immediate post-partum phase [25,26,37] and six focused on the postnatal phase [22,27-29,34,37] as illustrated in Table 1.…”

“…Six studies [29-32,37,38] included women with gestational diabetes as well as those with T1DM but our current review focused only on data relating to women with T1DM. Samples of women with T1DM ranged N = 7-23 in the qualitative studies and N = 30-105 in the quantitative studies.…”

“…Samples of women with T1DM ranged N = 7-23 in the qualitative studies and N = 30-105 in the quantitative studies. In five studies [31,32,35,37,38], it was not possible to determine the exact number of women with T1DM included.…”

“…Women with pre-existing diabetes reported that pregnancy placed a greater strain on them compared to pregnant women without diabetes [28,34]. Increased ambivalence or doubts, coupled with fear of losing the unborn child, can interfere with the normal adjustment to pregnancy [32] and can trigger a sense of disempowerment, high levels of worrying, depression, guilt and fear of being a ‘burden’ to others [25,27,35]. …”

Coping strategies for postpartum depression: a multi-centric study of 1626 women

“…Coping strategies are considered relevant for infant developmental outcomes (Levy-Shiff et al 1998;Levy-Shiff et al 2002) and postpartum depression (Terry et al 1996;Honey et al 2003a;de Tychey et al 2005). Mikulincer and Florian found that avoidant women showed weak attachments to their fetuses and showed negative mental health in the first and third trimesters of their pregnancies (Mikulincer and Florian 1999).…”