1,721,008 research outputs found
Infant-Directed Speech to preterm infants in the first year postpartum: the influence of severe premature birth and maternal postnatal depression
Full text linkIntroduction: Preterm birth could negatively influence the quality of mother-infant interactions during the first year of life. To date, few studies have investigated the effects of prematurity on the features of maternal input during interactive patterns, especially considering the role played by the severity of prematurity and maternal postnatal depression (PND). This study aimed to describe functional and morpho-syntactic features of maternal Infant-Directed Speech (IDS) in preterm dyads, exploring the influence of maternal PND and severity of prematurity, comparing dyads of Extremely Low Birth Weight (ELBW; <1000 gr.), Very Low Birth Weight (VLBW; 1000-1500 gr), and Full-Term (FT) babies. Methods: At 3 and 9 months postpartum (corrected age for preterm infants), sixty mother-infant dyads (15 ELBW, 15 VLBW, 30 FT) freely interacted for 5 minutes. Lexical, syntactic, and functional features of maternal input produced during the interaction were analyzed using the CHILDES software. Moreover, maternal PND symptomatology was assessed using the Edinburgh Postnatal Depression Scale. Results: At 3 months, maternal IDS in high-risk conditions (PND or ELBW preterm condition) showed a lower frequency of affect-salient speech (F(2,49)=10.83, p=.002; F(2,49)=3.60, p=.034, respectively) and a higher proportion of questions (F(2,49)=6.61, p=.013; F(2,49)=3.32, p=.043, respectively) and directives (PND: F(2,49)=4.39, p=.040) compared to IDS produced by non-depressed mothers and those of FT and VLBW infants, respectively. At 9 months, mothers with higher levels of PND showed an IDS characterized by lower verbosity (F(2,49)=4.602; p=.032) and higher frequency of attention-getter utterances (F(2,49)=6.911; p=.009) than mothers with lower levels of PND. Discussion: Despite preliminary, these findings highlighted that maternal IDS might be influenced by both the presence of depressive symptoms and severe prematurity. Moreover, IDS features seemed to change during the first year postpartum, suggesting the need to monitor the influence of both the severity of preterm birth and the presence of PND on the features of maternal input directed to the infant
The dimensions of the transition to parenthood in fathers after assisted reproductive technology
Full text linkPerinatality represents a major life transition period for future parents for the activation of the caregiving system and the development of early parenting skills. This transition may be influenced by specific contexts of parenthood, such as infertility and the need to undergo Assisted Reproductive Technologies (ART), which are known as highly stressful events. Nevertheless, literature on parenthood after ART has focused on mothers and less on fathers’ experience. This study aimed to investigate the transition to parenthood in fathers after ART treatments, analysing the quality of both parental mental representations and father-infant interactive styles according to modality of conception (ART vs Spontaneous Conception, SC).
Forty-two fathers (17 ART, 25 SC) and their partners were recruited at Santa Maria Nuova Hospital (Reggio Emilia, Italy) during the antenatal period. The quality of parental representations was assessed at 32 gestational weeks and 3 months after childbirth, by the Semantic Differential of the IRMAG. Father-infant interactive patterns were also evaluated after birth during 5 minute-free interactions, coded by the CARE-Index.
Results showed similar mental representations between ART and SC fathers in individual (Child, Self-as-man, Partner) and parental (Self-as-parent, Own parent) characteristics. Nevertheless, ART fathers showed higher scores in Emotional Tendencies, suggesting a more intense involvement in the parenting role.
Father-infant interactions showed a similar level of sensitivity between ART and SC fathers and infants were cooperative in both groups. Anyway, considering the influence of the type of ART, infants whose fathers underwent ICSI procedure showed to be more passive.
Findings suggest the need to further investigate paternal experience during transition to parenthood after ART, to improve the understanding of fathers’ difficulties and resources in developing their parental role and possibly to target specific parenting support
Prematurità e sintomatologia depressiva perinatale paterna: decorso e qualità delle interazioni diadiche nel primo anno di vita
No full textLa nascita pretermine rappresenta un fattore di rischio per la transizione alla genitorialità, con un aumentato tasso di insorgenza di psicopatologia perinatale. La letteratura si è a lungo focalizzata sulla sintomatologia delle madri di bambini prematuri, mentre solo recentemente la ricerca sta indagando gli effetti sugli stati affettivi paterni. Lo studio si propone di indagare il decorso della sintomatologia perinatale paterna durante i primi 12 mesi di vita, valutando l’impatto della severità della prematurità e del livello di stress genitoriale. È stato inoltre valutata la qualità delle interazioni precoci padre-bambino, considerando l’effetto della prematurità, della sintomatologia depressiva e dei livelli di stress paterni. Lo studio ha coinvolto 165 padri ed i loro bambini, di cui 80 nati a termine e 85 di prematuri, a loro volta suddivisi in 47 Very Low Birth Weight (VLBW: peso alla nascita 1000-1500 gr) e 38 Extremely Low Birth Weight (ELBW: peso alla nascita <1000 gr). A 3 e 12 mesi di età corretta del bambino, i padri hanno compilato l’Edinburgh Postnatal Depression Scale (EPDS) e il Parenting Stress Index-Short Form (PSI-SF). Inoltre, in un sottocampione di diadi (23 padre-bambino nato a termine, 23 padre-bambino prematuro), la qualità dell’interazione diadica è stata valutata tramite il Child-Adult Relationship Index (CARE Index). A 12 mesi, i padri ELBW hanno mostrato un significativo decremento dei punteggi medi PSI-SF totale rispetto a quelli ottenuti a 3 mesi. I punteggi EPDS paterni a 12 mesi risultavano significativamente predetti dalla severità della nascita pretermine e dai punteggi EPDS e PSI-SF a 3 mesi. Infine, la nascita ELBW prediceva significativamente migliori pattern interattivi sensibili (padri) e cooperanti (bambino) al CARE Index. I risultati dello studio evidenziano la rilevanza del monitoraggio longitudinale dell'esperienza affettiva della paternità in un contesto di potenziale vulnerabilità quale quello della nascita pretermine
La nascita pretermine e la sintomatologia depressiva materna nel primo anno di vita del bambino
No full textLa nascita prematura può aumentare la vulnerabilità ai problemi di salute mentale per entrambi i genitori, in particolare per le madri, più coinvolte nel processo di accudimento e cura del bambino. Tra questi, la depressione perinatale nel postpartum (DPN) è uno dei disturbi psichici più diffusi con importanti implicazioni per la costruzione della relazione diadica e per lo sviluppo infantile. Con queste premesse, questa rassegna si propone di riassumere la letteratura empirica degli ultimi dieci anni sulla DPN nelle madri di bambini prematuri per fornire un quadro aggiornato sulla prevalenza, sul decorso e sui fattori di rischio connessi alla DPN, nonché sull’impatto della DPN e della prematurità sulla qualità della relazione e sullo sviluppo infantile nel corso del primo anno di vita del bambino. In più, con l’obiettivo di fare chiarezza sulle implicazioni cliniche ed empiriche di questi studi, cercheremo di comprendere se e come variano gli esiti della nascita prematura in relazione alla severità della prematurità. Dal punto di vista clinico emerge la necessità di avviare con prontezza screening diagnostici per la DPN, soprattutto in caso di prematurità ad alto rischio, di monitorare il decorso della DPN per identificare le donne più a rischio di cronicità, e di pianificare interventi utili a favorire la costruzione di un’interazione diadica positiva che, a sua volta, è un fattore protettivo per lo sviluppo del bambino. Dal punto di vista empirico si evidenzia la necessità di studiare gli effetti della prematurità sulla DPN tenendo conto della gravità della prematurità, e di fare chiarezza sui possibili decorsi della DPN per comprendere se e come variano le conseguenze per la relazione e lo sviluppo del bambino.A premature birth can result in increased vulnerability to mental health problems for parents, in particular for mothers, more involved in the infants' caregiving. In this context, perinatal postpartum depression (PPD) is one of the most common disorders with important consequences for the building of dyadic relationship and for infants' development. With these premises, this review is aimed at summarizing the empirical literature of the last 10 years on perinatal postpartum depression in mothers of premature infants for providing an up-to-date picture on prevalence, course and risk factors connected to PPD, also on the impact of PPD and of prematurity on the quality of early dyadic relationship and on infants' development across the first year postpartum. Moreover, for discussing clinical and empirical implications of these studies, this review is aimed at illustrating how and if the impact of a premature birth changes according to the severity of prematurity. From a clinical perspective it emerges the need of promptly screening for PPD, above all in case of high risk prematurity, of monitoring the PPD' course for identifying women at higher risk for chronicity, and of planning interventions for promoting a good mother-infant interaction who, in turn, is a protective factor for infants' development. From an empirical perspective it emerges the need of exploring the impact of prematurity on PPD taking into account the severity of prematurity, and of studying the different courses of PDD for understanding how they impact on dyadic relationship and on infants' development
Promozione della salute nella prima infanzia
No full textL’Organizzazione Mondiale della Sanità (1948) ha definito la salute come «uno stato di completo benessere fisico, mentale e sociale e non semplice assenza di malattia». Tale definizione ha posto l’attenzione verso la messa in atto di interventi ma atti a promuovere la condizione psicofisica della persona in ottica supportiva e preventiva. Tra questi, l’OMS ha riconosciuto gli interventi preventivi nel periodo perinatale (dalla gravidanza al primo anno di vita del bambino) come una risorsa fondamentale per la promozione della salute e per la riduzione dei rischi che possono intervenire precocemente nello sviluppo determinando percorsi evolutivi disadattivi verso la psicopatologia. Tali interventi partono dal presupposto che la transizione alla genitorialità costituisca un periodo sensibile, in cui la persona sperimenta una maggiore recettività alla possibilità di cambiamento. Infatti, nonostante la transizione alla genitorialità sia riconosciuta come un evento potenzialmente critico per l’equilibrio familiare, la necessità di riorganizzazione della relazione diadica attivata fin dalla gravidanza, unita alla prospettiva futura dell’arrivo del bambino, sono elementi che possono rendere i futuri genitori particolarmente recettivi al cambiamento e agli obiettivi dell’intervento.
Date queste premesse, l’obiettivo del capitolo sarà quello di fornire un quadro della transizione alla genitorialità nell’ottica della psicologia della salute. In particolare, sarà presentato il contesto della nascita pretermine, quale esemplificazione del complesso intreccio tra fattori di rischio e protettivi in ottica diadica e familiare. Saranno quindi presentati i principali modelli di intervento attivi per la promozione della salute di tali famiglie
Psychological adjustment of infertile couples in the postpartum period: the characteristics of parental mental representations and early parent-infant interactions
Full text linkClinical and empirical literature has recognized Assisted Reproductive Technology (ART) as a stressful condition that may impact on psychological transition to parenthood during pregnancy. However, poor attention has been paid to investigate parental adjustment in the postpartum period, a crucial moment for the parent-infant relationship. We therefore aimed to investigate transition to motherhood and fatherhood in the postnatal period, discussing an overview of recent studies on postnatal outcomes (parental representations and parent-infant interactions) of infertile couples after a successful ART treatment. The first study included a sample of 17 ART conceiving and 25 spontaneous conception (SC) couples; at 3 months postpartum all parents completed the Semantic Differential of IRMAG/IRPAG (Interview of Maternal/Paternal Representations During Pregnancy; Ammaniti et al., 1992, 1995, 2006), a self-report tool to evaluate domains of mental representations according to individual (Child, Self-as-womanman, and Partner) and parental (Self-as-parent, Own parent) characteristics. The second study aimed to assess the quality of a 5-minute free parent–infant interaction on 25 ART and 31 SC couples and their 3-month-old baby. Fathers, mothers and babies’ interactive patterns were coded using CARE-Index (Crittenden, 1994). Results on mental representations showed that both ART mothers and fathers had significantly higher positive representations of the Child than SC ones. The type of ART treatment (IVF/ICSI) showed a significant influence on the representation of Self-as-woman/man, with higher positive scores in IVF parents compared to ICSI ones. Regarding parent-infant interactions, both ART mothers and fathers showed more frequently “inept” and “at-risk” interactive patterns, compared to SC ones. ART variables significantly influenced interactive behaviours: infants conceived at first ART cycle showed lower scores at Difficulty scale than those conceived after more attempts; ICSI babies got lower scores at Compulsivity and higher at Passivity compared to IVF ones. These findings support the clinical relevance of exploring parents’ psychological adjustment after successful ART treatments, to improve the understanding of the transition to parenthood in infertile couples and to target more specific interventions when needed
Infant-Directed Speech to preterm infants: the influence of severe prematurity and maternal depressive symptoms.
No full textIntroduction
Severe preterm birth represents a risk factor for maternal perinatal depression and the quality of early dyadic interactions in the first year postpartum (Agostini et al., 2014; Neri et al., 2015). However, only few studies explored the effect of preterm condition on interactive exchanges, including maternal verbal input (Herrera et al., 2004; Suttora & Salerni, 2011), and no one considered the role played by severity of prematurity.
Aim The study aimed to explore the influence of prematurity and maternal depression on functional and morpho-syntactic features of maternal Infant-Directed Speech, comparing dyads of Extremely Low Birth Weight (ELBW; <1000 gr.), Very Low Birth Weight (VLBW; 1000-1500 gr) and Full-Term (FT) babies. Material and Methods Sixty mother-infant dyads (15 ELBW, 15 VLBW, 30 FT) were recruited and participated in a 5 min free interaction session at both 3 and 9 months postpartum. Lexical, syntactic, and functional features of maternal input during the interaction were analyzed using the
CHILDES software. All mothers completed Edinburgh Postnatal Depression Scale (Cox et al.,1987) to assess depressive symptoms. At 3 months, maternal IDS in high-risk condition (ELBW preterm condition and depression) was characterized by a lower frequency of affect-salient speech and a higher proportion of informationsalient speech and questions. At 9 months, IDS of depressed mothers was characterized by a lower verbosity and a higher frequency of attention-getter utterances. Conclusions Despite preliminary, these findings highlight that maternal IDS might be influenced by both the presence of depressive symptoms and severe prematurity. Moreover, IDS features seemed to change during the first year postpartum, suggesting the need to monitor the influence of severity of preterm birth and its interaction with postnatal depression on the features of maternal input directed to the infant
DIFFERENTIATING TRANSIENT AND ENDURING DISTRESS USING THE EDINBURGH POSTNATAL DEPRESSION SCALE DURING PREGNANCY
No full textThe Edinburgh Postnatal Depression Scale is a widely-used instrument both in research and in clinical settings for screening depression in the perinatal period. It is generally administered only once, although some authors suggest a two-stage screening procedure plus an interview to confirm the presence of depression. Several studies have demonstrated that more than half of women who scored high on the EPDS, when re-tested a few weeks later, no longer scored high. Matthey & Ross-Hamid (2012),in their antenatal study, define this phenomenon as “transient distress”, that is normal distress that can occur in early gestational age, distinguishing it from the kind of distress that is still present when patients are re-tested (“enduring distress”).The aim of this study was to investigate whether the scores obtained at the third trimester of pregnancy were related to “transient”
or “enduring” distress, and in particular whether there was a difference between rates obtained in the early second trimester and in the period examined in the present study, the late third trimester.
98 Italian women in their third trimester of pregnancy (Time 1, T1), recruited from antenatal classes, were asked to fill in a series of self-report questionnaires, including EPDS.Approximately 1-6 weeks later (Time 2, T2), 86 of them were re-tested. The data have been analysed using the cut-off score of 10 or more. At T1, 26% of participants scored high; at T2 half of the women (13 out of 22, or 59%) who scored high at T1 no longer scored high. Very few (3 out of 64, or 5%) who scored low at T1 scored high at T2.
The present findings confirm the need to endorse the practice of a double administration of EPDS for women who initially score high
Trajectories of perinatal depressive symptoms in preterm infants’ parents: the influence of severity of prematurity and of parental role
Full text linkPrematurity is widely recognized as a significant risk factor for both maternal and paternal perinatal depression (PND). Nevertheless, little is known about the PND course during the first year of preterm infant’s life in both parents. Furthermore, literature usually focuses on parents of Very Low Birth Weight-VLBW babies (birth weight <1500 grams), while less attention is paid to Extremely Low Birth Weight-ELBW infants (<1000 grams), that represents a population of great clinical relevance, given the constant increase of their survival rate, the higher risk condition for later behavioural difficulties and for maternal depression. Given these premises, the aim of the study was to explore trajectories of PND in preterm mothers and fathers, according to severity of prematurity and parental role.
For the study 177 mothers and 177 fathers were recruited. According to infant birth weight, 38 parental couples were included in ELBW group, 56 couples in VLBW group and 83 in Full Term-FT group (birth weight >2500 g; gestational age >36 weeks). All parents fulfilled the Edinburgh Postnatal Depression Scale (EPDS) at 3, 9 and 12 months of infants age (corrected for preterm infants). Trajectories were tested by Growth Curve Models.
Results showed that, when birth weight was included in the models, ELBW parents had higher PND levels at 3 months and a greater decrease of symptoms over time compared to VLBW and FT groups. As a function of birth weight and parental role, the higher scores at 3 months and the greater decrease over time were evident only for ELBW mothers compared to VLBW and FT mothers and fathers; no differences emerged for ELBW fathers.
Findings suggest that severity of preterm birth and parental role may lead to different affective dysregulations across time, with ELBW mothers being at higher risk for PND especially in the first months after discharge. Clinical implications for intervention on parenthood in the perinatal period will be discussed
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