Social support and maternal depression from pregnancy to postpartum: the association with positive maternal behaviours among Brazilian adolescent mothers

Adolescent motherhood is a risky situation related to poorer quality of infant caregiving. The lack of social support and increased odds for maternal depression are the main concerns. This study aimed to investigate whether maternal–foetal attachment, social support and maternal depression measured during pregnancy and after birth were associated with postpartum maternal behaviours among Brazilian adolescent mothers. Forty-one adolescent mothers participated (M_age?=?16.88 years; SD?=?1.60) in the first two waves of a longitudinal study. Both mother and infant behaviours were assessed during videotaped home observations at three months postpartum. Hierarchical regression analysis indicated that positive postpartum maternal behaviours were strongly related to concurrent, rather than prenatal, measures of social support and maternal depression. Infant birth weight was also associated with positive maternal behaviours. Findings contribute to a better understanding of the personal and contextual factors affecting maternal behaviours shortly after birth in a high-risk sample of adolescent mothers.     

Maternal depression and perceived social support as predictors of cognitive function trajectories during the first 3 years of life for preterm infants in Wisconsin

Background Among families of infants born preterm, the association between post‐natal depression and children's cognitive function is not well understood, but thought to be compromised. The purpose of this study is to investigate maternal depressive symptoms and perceived social support as predictors of children's cognitive function trajectories. Methods This is a longitudinal study of a sample of infants born preterm (less than 37 weeks) in Wisconsin. This study includes 130 infants who were hospitalized in one of three Wisconsin neonatal intensive care units in 2002–2005 and followed until 36 months of age. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Social support was measured using the Maternal Support Scale. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd Edition, and the Stanford–Binet Intelligence Scale, 5th Edition. Results Children's cognitive function trajectories declined initially and then increased. Being female (coefficient = 5.14, SE = 1.89) and non‐poor (coefficient = 11.26, SE = 5.78), and having a mother who has a graduate degree (coefficient = 7.67, SE = 3.37) was associated with higher levels of cognition initially. Being white was associated with a more optimal cognitive trajectory. Although depression did not predict children's cognitive trajectories, the presence of clinically elevated depressive symptoms at 9 months post term was associated with lower cognitive functioning at 16 months when mothers reported low social support. Conclusion Post‐natal depressive symptoms appear to have a meaningful, dynamic influence on the cognitive outcomes of children born preterm, above and beyond family socio‐demographic risk when the presence and timing of perceived social support are considered. Interventions to ameliorate developmental risk associated with preterm birth should include repeated assessments of maternal social support and post‐natal depression and be targeted towards socially disadvantaged families.     

The effects of social support on maternal anxiety and depression after stillbirth

While most births result in a live baby, stillbirth (the birth of a dead baby) occurs in nearly 1 in 110 pregnancies. This study examined whether levels of maternal anxiety and depression are lower amongst mothers who received social support after stillbirth. Using non-probability sampling, data were collected from 769 mothers residing within the USA who experienced a stillbirth within the past 18 months and for whom we have complete data. The study Maternal Observations and Memories of Stillbirth and the website http://www.momstudy.com containing the questionnaire were open in the period 8 February 2004–15 September 2005. Congruent with the family stress and coping theory, mothers of stillborn babies who perceived family support in the period after stillbirth experienced levels of anxiety and depression that were notably lower than those of their counterparts. Nurses, physicians and support groups also were important sources of support after a stillbirth; however, these sources of support alone were not statistically significant in reducing anxiety and depression in grieving mothers. Community interventions should focus on the grieving mother and her family system , including her partner and surviving children.     

母亲抑郁对儿童综合发展的影响

母亲抑郁是指孕期或产后发作的非精神病性抑郁障碍。母亲抑郁不仅会引起孕产妇的躯体和精神症状,还会对子代发育造成影响。许多流行病学研究结果表明孕产妇抑郁影响胎儿宫内发育,还会引起儿童的内化和外化障碍等一系列健康问题,甚至与成年期的精神状态都有着密切的联系。本文从母亲抑郁与新生儿结局和儿童的认知、行为、情绪、身体健康状况等方面进行综述,以期探索母亲抑郁与儿童发展的关联,并为今后开展相关研究提供科学依据。     

Development of spontaneous grandparent–infant imitation across the first year of life

The aim of the present study was to explore and compare systematically the developmental patterns of certain aspects of imitation, longitudinally from 2 to 10 months, in interactions of infants with grandfathers and grandmothers. Sixteen infants were video-recorded at home in the course of spontaneous dyadic interactions with maternal grandfathers and grandmothers. Micro-analysis of imitative episodes provided evidence of similarities in the developmental pattern of infant imitations, totally and of certain imitated acts, and infant turn-taking imitations, while differences were found for infant imitation, totally, and for vowel–consonant imitation, the developmental pattern of infant co-actions and facial expression imitations. Grandfathers and grandmothers offer infants a sense of consistency – with predictable and overlapping behaviours – and a redundant variety of stimulatory and unique communications. It is assumed that grandfathers constitute carefully attentive, sensitive communicating partners and unique emotional components of infants’ social experience who promote adaptive development.     

Anxiety and depression in the first year of medical residency training

OBJECTIVE: To perform a screening, follow-up and comparative evaluation of depression and anxiety symptoms in a group of 59 first-year internal medicine residents of a teaching hospital and evaluate the influence of their rotation, nature of rotation, subgroup, sex and the time of year on these symptoms. METHODS: We used the Spielberger State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI), applied seven times, in the last week of every rotation. RESULTS AND CONCLUSION: We obtained two identical averages (P=0.98) of trait-anxiety, six months apart one from the other. There was a significant correlation (R=0.65, P < 0.001) between the indexes of state-anxiety and depression. Women had higher levels of symptoms of both anxiety and depression (P < 0.001) compared to men. A cluster of three subgroups of residents with higher trait-anxiety levels (P=0.001) also showed significantly higher levels of symptoms of state-anxiety and depression (P < 0.001). The time of the year and the nature of the rotation (emergency or not) did not interfere with the levels of depression (P=0.47). We detected rotations where there was greater frequency of residents with symptoms compatible with moderate and severe depression. There were 2.1% of residents with symptoms compatible with severe, 4.2% with moderate and 27% with mild depression. It was possible to graduate symptoms of anxiety and depression in residents, evaluate factors involved in their genesis and locate residents with moderate and severe depression.     

The influence of maternal depression, caregiving, and socioeconomic status in the post-natal year on children's language development

Background   Post-natal depression is common and has been associated with adverse effects on children's later emotional and behavioural development. The evidence for effects on children's cognitive development is unclear but this could potentially be a major public health issue. The aim was to examine whether maternal depression and maternal caregiving during the first year of life are associated with children's subsequent language development.
Methods   One thousand two hundred and one women were recruited from antenatal and post-natal baby clinics in two areas in England, and followed up until their babies were 3 years. Mothers and children were assessed by questionnaire, interview and home observation; 999 children's language was assessed at 36 months, although 55 were excluded principally because they had been exposed to insufficient English.
Results   In bivariate analyses maternal depressive symptomatology in the post-natal year but not at 36 months was associated with poorer child language at 36 months; maternal caregiving, was positively associated with language. Structural Equation Modelling revealed that depression was associated with poorer caregiving but was not independently associated with language. Higher quality caregiving at 10 months was associated with better language. When the sample was split by socioeconomic factors the effects of depression on caregiving were stronger in the less advantaged group. In both groups poorer quality early caregiving predicted lower language outcome.
Conclusions   Post-natal depression had a negative effect on caregiving, which in turn affected language; post-natal depression did not have an additional direct effect on language. Socioeconomic factors moderated the effects of depression on caregiving. When targeting interventions at mothers with post-natal depression, it may be strategic to focus on lower socioeconomic groups at higher risk.     

围生期身心健康干预对阴道分娩产妇依从性及抑郁焦虑状态的影响研究

目的探讨围生期身心健康干预对产妇阴道分娩依从性及抑郁焦虑状态的影响。方法选取十堰市太和医院2014年4月至2015年12月收治的146例产妇,按随机数字表法分为研究组和对照组,每组各73例。对照组实施围生期常规护理干预措施,研究组则在对照组的基础上进行护理身心健康干预。运用问卷调查的方法采集两组产妇对护理工作的满意度和遵医嘱行为以及纯母乳喂养等情况,同时运用自评量表测评两组产妇分娩前后焦虑和抑郁等情况。结果研究组产妇阴道分娩依从性、对护理工作的满意度和纯母乳喂养的比例均优于对照组;两组护理干预后焦虑自评量表、抑郁自评量表和爱丁堡产后抑郁量表评分均显著低于护理前;研究组各量表评分较对照组下降更为明显,护理前后评分差值明显大于对照组,以上各项结果差异均有统计学意义(P0.05)。结论对孕产妇实施围生期护理身心健康干预措施能够有效提高孕产妇的临床依从性和对护理工作的满意度,同时能改善围生期的焦虑及抑郁状态。     

The effect of maternal depression and marital adjustment on young children's internalizing and externalizing behaviour problems

BACKGROUND: The present study aimed to clarify the circumstances under which maternal depression is associated with adverse outcomes in pre-school-aged children, and to explore the additional impact of the marital relationship in a socio-economically low-risk sample. METHODS: Ninety-two mothers recruited into a longitudinal study were assessed for symptoms of depression when their children were 4, 12 and 15 months, and later at 4 years of age. At 4 years of age, mothers were also asked to report on marital adjustment. Mothers, fathers and pre-school teachers were asked to report on children's internalizing and externalizing behaviour problems. RESULTS: Children exposed to chronic maternal depression were rated by their parents as significantly more problematic on internalizing and externalizing behaviours. This association was not mediated or moderated by low marital satisfaction. No parent-reported effects were evident for children exposed to transient depression. Ten per cent of the children had internalizing scores in the clinical range, and 7% had externalizing scores in the clinical range. Almost all of the children with clinically elevated scores had been exposed to chronic maternal depression. Teacher reports of internalizing behaviours corroborated parent reports; however, teachers tended to report significantly lower levels of behaviour problems. Although there was a tendency for teachers to rate children exposed to any depression as more problematic on internalizing behaviours, the subgroup differences were not significant. CONCLUSIONS: Findings confirm that depression chronicity is important in determining child behavioural outcomes, and that depression effects cannot be accounted for by low marital adjustment. Results are discussed with reference to transmission of risk models, and treatment implications are considered.     

Parents''attitudes to developmental screening in the first year of life

It has been suggested that screening for impairment in early childhood may cause anxiety to parents. Using self-administered questionnaires, we studied the attitudes and concerns of parents of infants aged 6 months and 8-9 months. Parents were randomly allocated to one of two groups. One group completed the second questionnaire after the 8-month assessment routinely performed by health visitors, and the other group completed the second questionnaire before the assessment. We showed changes in attitude and concerns over the 2-3 month period, but these were not related to the assessment. It appeared that particular concerns and anxieties were not resolved by a recent contact with a health visitor, although a high proportion of mothers stated that they found the assessment reassuring. There was some evidence of a lack of appreciation, both of the purpose of the tests and of the implication of test failure. Screening tests performed by health visitors at an age of 8 months do not appear to generate undue anxiety in parents. However, as many of the tests used are of doubtful validity, a review of the purpose and content of this early health visitor assessment is needed.     

Weight gain during the first year of life in relation to maternal smoking and breast feeding in Norway.

OBJECTIVE: To assess the weight gain during the first year of life in relation to maternal smoking during pregnancy and the duration of breastfeeding. DESIGN: This was a one year cohort study. SETTING: The city of Oslo, Norway. PARTICIPANTS: Altogether 3020 children born in Oslo in 1992-93. Children were divided into three groups as follows: 2208 born to non-smoking mothers, 451 to mothers who were light smokers (< 10 cigarettes per day), and 261 to mothers who were heavy smokers (> or = 10 cigarettes per day). MAIN RESULTS: The mean birth weights were 3616 g, 3526 g, and 3382 g and 1 year body weights were 10,056 g (gain 6440 g per year), 10,141 g (6615 g), and 10,158 g (6776 g) in children of non-smoking and light and heavy smoking mothers respectively. Cox regression analysis showed that children of heavy smokers were 2.0 (95% confidence interval, 1.7, 2.3) times and children of light smokers 1.3 (1.2, 1.5) times more likely to have stopped breast feeding during their first year of life compared with children whose mothers were non-smokers. Linear regression analysis, adjusting for confounders, showed that weight gain was slower in breast fed children than in those who were not breast fed (-38 g (-50, -27) per month of breast feeding). Compared with children of non-smokers, the adjusted weight gain was 147 g (40, 255) per year greater in children of light smokers and 184 g (44, 324) per year in children of heavy smokers. CONCLUSION: Children catch up any losses in birth weight due to maternal smoking, but some of the catch up effect is caused by a shorter duration of breast feeding in children of smoking mothers.     

Deleterious effects of the prone position in the full-term infant throughout the first year of life

Summary Seventy-one first-born infants who had been nursed in prone position since birth, were referred for motor assessment at 3 months, 5 months and 9 months. All infants were administered the same checklist of motor items, based on the Amiel-Tison Infant Neurological Evaluation and on the Brunet-Lézine Developmental Psychomotor Scale. Abnormalities in muscular shortening and delay in motor skills were found. These findings are critical as regards environmental influences on postural development, continuities in motor development and issues of early primary prevention. Early identification and follow-up programmes, including frequent changes in posture, are suggested in order to avoid abnormalities of motor behaviour and subsequently in postural patterns.     

Maternal perinatal depression: emotional development in offspring from infancy to adolescence

Maternal perinatal depression is not an uncommon experience, yet few mothers are identified and treated – a concerning fact, given the potential for negative impact on both maternal and infant well-being. In the present study, I review recent research in the field of maternal perinatal depression and highlight associated developmental outcomes among offspring in physiological, cognitive, behavioural, and socio-emotional domains. Developmental outcomes – and more specifically, the pathways by which these outcomes develop – are explored among offspring in infancy, childhood, and adolescence. Specific attention is given to research exploring (at both macro- and micro levels) the interactional processes that occur between mothers with depression and their offspring. Ultimately, the review identifies a need to continue to develop and apply novel research methodologies to further understand the interactional processes that occur between mothers and their offspring in the context of maternal depression, and specifically how these interactions develop across the span of offspring development.     

Biography of the first year: A case study integrating psychoanalytic, cognitive-developmental and mother-infant systems perspectives

A case study of a normal infant's first year of life is interpreted in terms of psychoanalytic, cognitive-developmental and mother-infant systems perspectives. While each of these approaches highlights different aspects of the developmental process, a complementary relationship is established among them on the basis of important conceptual convergences and mutually compatible predictions. After the models themselves are reviewed and compared, they are applied to case material collected from parent interviews and direct observations of one child. The objective is to generate a comprehensive “biography” of this baby's early personality development by a weaving together of diverse theoretical strands. A working relationship among the theories is demonstrated through the analysis of the case material, while interpretation of the material itself is enriched by the variety of vantage points applied to it.     

湖南省妇幼保健机构产后抑郁症防治现状及需求研究

目的通过对全省妇幼保健机构的抽样调查,了解产后抑郁症的防治能力和需求状况,为下一步有针对性地指产后抑郁症防治的开展,制定适合三级妇幼保健网络的孕产期心理保健方案奠定基础。方法采取多阶层随机整体取样的方法抽取湖南省16家妇幼保健机构和179位医务人员。结果在16所调查的妇幼保健机构中,开展了产后抑郁症筛查的机构7所,占43.8%,开展了心理咨询门诊的4所,占25.0%,配备了心理疏导、心理治疗设施设备的2所,占12.5%。179名被调查的医务人员中,有68.7%的认为所在机构对产后抑郁症的防治不能满足孕产妇的需求。结论全省妇幼保健机构对产后抑郁症的识别和干预机制不健全,网络覆盖不全面,医务人员的服务能力不强,下一步应逐步完善防治网络和强化能力建设。     

Eating habits in the first year of life

The study aimed to examine the relevant published literature to food practices in the first year of life of teenage mothers' children, through an integrative review within Lilacs, Medline and Cochrane, databases from 2000 to 2010. We used the keywords: adolescent, breastfeeding, mixed feeding and infant nutrition, from which we selected eleven articles that composed the study sample. The results indicated the paucity of published research on the proposed topic, especially for those focusing on complementary feeding, revealing a gap in global production on the subject. New researches, therefore, need to be developed with a focus on teenage mothers, exploring infant feeding in all its dimensions.     

产妇产后抑郁对婴儿喂养方式及婴儿体重的影响调查

目的 调查分析产妇产后抑郁对婴儿喂养方式及婴儿体重的影响,探讨产妇产后情绪干预对策,提升母婴健康。方法 选择2017年3月—2019年2月成都市第二人民医院分娩的80例符合纳入条件的孕妇为研究对象,采用爱丁堡产后抑郁量表(edinburgh postpartum depression scale,EPDS)于产后4周对产妇实施EPDS调查,EPDS评分≥13分产妇设为观察组(38例),EPDS评分＜13分产妇设为对照组(42例),分别于产后4周、8周、12周、16周跟踪收集两组产妇泌乳情况(泌乳量、母乳喂养次数)、喂养方式、新生儿体重情况并进行比较。结果 观察组产妇产后4周、8周、12周、16周泌乳量、母乳喂养次数均低于对照组(P＜0.05);观察组产后8周、12周、16周纯母乳喂养率均低于对照组(P＜0.05);观察组产后4周、8周、12周、16周婴儿体重增长重量均低于对照组(P＜0.05)。结论 产妇产后抑郁情绪降低产妇乳汁分泌量、喂养婴儿次数及纯母乳喂养率,降低婴儿体重增长速度,不利于婴儿健康成长,产前应加强孕妇情绪相关健康知识宣教,产后应加强产妇心理干预以降低产后抑郁症发生,提高母婴健康水平。     

Immune response to vaccine adjuvants during the first year of life

Subunit vaccine formulations often include adjuvants that primarily stimulate innate immune cells. While young infants represent the major target population for vaccination, effective immunization in this age group remains a challenge. Many parameters of innate immune responses differ quantitatively and qualitatively from newborns to infants and adults, revealing a highly regulated developmental program. Herein, we discuss the potential implications of innate immune ontogeny for the activity of adjuvants contained in licensed infant vaccines, as well as future directions for rational design of adjuvanted vaccines for this age group.