Nadine Fink
Psychoneuroendocrine Stress Reactivity during Pregnancy
Authors
Nadine Fink (Frauenklinik des Universitaetsspitals Basel)
Judith Alder (Frauenklinik des Universitaetsspitals Basel)
Johannes Bitzer (Frauenklinik des Universitaetsspitals Basel)
Wolfgang Holzgreve (Frauenklinik des Universitaetsspitals Basel)
Irene Hösli (Frauenklinik des Universitaetsspitals Basel)
Objectives: Maternal stress during pregnancy is associated with changes of the utero-placentar entity and can lead to enduring effects on the developing child. The aim of the present study is to investigate the relationship between maternal psychological state, physiological measures of the fetus (fetal heart rate (fHR), fHR-variability and movement patterns) as well as maternal endocrine stress reactivity.
Method: 26 women underwent standardized stress induction tasks during the 28.-32. week of pregnancy. Maternal endocrine and sympathetic reactivity, anxiety, depressive symptoms and life stress (STAI, GAS, EPDS, TICS, VAS) as well as fetal parameters (fHR, fHR-variability and movement patterns) were assessed.
Results: Maternal personal stress and job strain were associated with fHR and fHR-variability. There was more fetal movement during the stress induction tasks among children of mothers with higher STAIx2-values.
Conclusion: Particularly in reaction to psychological strain, maternal stress has an impact on fetal parameters. Maternal well-being and stress during pregnancy should be subject to prenatal care. There are effective stress reduction interventions, which, however, have not yet been evaluated with regard to their effect on the maternal-fetal entity.
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Chantal Jaussi
Predictors of acute stress reactions and symptoms of depression in the first week following childbirth
Authors
Chantal Jaussi (University of Berne and University of Basel)
Werner Stadlmayr (University Hospital Berne)
Background: There is burgeoning research on posttraumatic stress (PTSD) and postpartum depression (PPD) in the later aftermath of childbirth, but there are few data on acute stress reactions (ASR) or symptoms of depression (SD) in the first 3 weeks postpartum although they may represent potential precursors of PTSD or PPD and have long-lasting effects.
Objectives: The aim of this study was i) to describe the week-to-week course of ASR and SD from week 1 to week 3 after childbirth, ii) to find out to what extent the EPDS would also detect women with high ASR either in week 1, 2 or 3 iii) to analyse the predictive values of intra-event variables for the development of ASR and SD in week 1 postpartum.
Method: In a sample of 220 new mothers intra-event variables (relationship with caregivers, birth experience, subjective stress experience as well as obstetric variables) were assessed 48-96 h. postpartum, as were ASR (by means of Impact-of-Event Scale IES) and SD (by means of Edinburgh-Postnatal-Depression Scale EPDS) in weeks 1, 2 and 3 after birth.
Results and Conclusion: ASR decline constantly from week 1 to week 3 with low ASR and high ASR in week 1 being highly predictive for normal ASR, and traumatogenic ASR in weeks 2 and 3, respectively. Peritraumatic emotional experience and lack of support from the caregivers’ team are major predictors of medium or high ASR in week 1.
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Daniela Bielinski-Blattmann
Trajectories of postnatal depression in the first 18 months after childbirth: An exploration of determinants
Authors
Daniela Bielinski-Blattmann (University of Berne)
Sakari Lemola (University of Basel)
Alexander Grob (University Hospital Berne)
Objectives: The purpose of this study is to advance understanding as to how the different courses of postpartum depression, assessed as non depressive symptoms, depressive symptoms and improvements in depression, 5 and 17 months after child birth are influenced by psychosocial protective and risk factors.
Method: Protective and risk factors were assessed in a community sample of initially 458 mothers in a prospective 3-wave study across the first 17 months after childbirth with regard to their characteristics of postpartum depression measured with the Edinburgh Postnatal Depression Scale (EPDS) and calculating the clinical significance by the Reliable Change Index (RCI).
Results and Conclusion: A logistic regression model revealed that the emotional support of the partner in the marital relationship 17 months after child birth is a major predictor for the course of postpartum depression. The results are discussed with regard to the perceived support of the partner as a factor important for the course of postpartum depression between 5 and 17 months after a child is born.
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Michael Pluess
Influence of Personality on Maternal Distress during Pregnancy and at Four Years Postpartum
Authors
Michael Pluess (University of Basel)
Margarete Bolten (University of Basel)
Objective: Empirical studies repeatedly found associations of prenatal maternal stress with negative child development. Findings in animal studies suggest that stress-induced hormonal changes in the mother during sensitive periods of the pregnancy lead to persistent changes in the child. The possibility that offspring may inherit maternal personality traits that account for both the maternal stress and the offspring behavior has received little attention. The current study was to investigates the relationship between maternal personality and psychosocial measures commonly used in studies on the effects of prenatal maternal distress.
Methods: Maternal reports of personality (16PF), perceived stress (PSS), depression (EPDS), anxiety (PDQ, STAI), life events (LES), and social support (F-SOZU) were collected during pregnancy (N = 76) and 4 years later (N = 44).
Results: All prenatal and several postnatal stress-related measures correlated with prenatally assessed neuroticism. According to multiple regression models neuroticism emerged as highly significant predictor for both prenatal and postnatal psychological distress when controled for sociodemographic and psychological measures.
Conclusion: Studies aiming at investigating the effects of maternal prenatal distress on child development that do not control for maternal personality traits may be substantially biased by neuroticism and must therefore be interpreted with caution.
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Wernr Stadlmayr
Ultrasound triggered mental representations of the infant at 20 weeks of pregnancy – presentation of the assessment tool TC_sono20
Authors
Wernr Stadlmayr (Universitätsfrauenklinik Bern)
Chantal Jaussi (University of Berne and University of Basel)
Matthias Meyer-Wittkopf (Universitätsfrauenklinik Bern)
Daniel Surbek (Universitätsfrauenklinik Bern)
Zack Boukydis (Erikson Institute, Chicago (USA))
Background: Ultrasound-based imaging is performed in far more than 90% of all pregnancies. This method has been explored with respect to emotional reactions of pregnant women; however, to date no systematic study on the shared internal world of mental representations in the parents-to-be has been presented. Triadic capacity (TC), i.e. the capacity to integrate the unborn child into a world of shared mental representations, has predictive value for the family’s development postpartum.
Objective: TC has so far been assessed by means of a standardized psychodynamically oriented interview. Using an ultrasound-based setting could be helpful to assess TC also in the clinical context of obstetrics: What are the pre-requisites of such a setting?
Method: Referring to two case-reports the four parts of TC_sono20 will be presented: Part 0: ‚How do I perceive the size of my baby? Part A: the sonographer, the pregnant woman, and her child; Part B: The parents-to-be and their child; Part C: The parents and the interviewer.
Results and conclusions: In assessing the first 30 parents we found differences in the experience between the various parts of TC_sono20 as well as between the couples. Differences were found in the following areas: (i) in the range of emotional and cognitive reactions of the involved individuals and (ii) in the capacity of the parents to share their experiences in the face of the ultrasound-conveyed baby. Details of these categories will be presented.
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