Controlling for other covariates, we found that prenatal diagnosis of congenital malformations was a significant independent predictor of acute parental psychological distress after birth.

Childbirth does not seem to trigger long term psychological distress in most parents. Clinically important psychological distress occurred more frequently in mothers than in fathers. Acute maternal psychological distress was predicted by being a single parent, being multiparous, and having a previous traumatic birth.

Fathers reported significantly more social isolation, but less role restriction, incompetence and state anxiety than mothers. The SPSQ together with GHQ-28 and STAI-X1 allow a targeted screening aimed at contrasting parents who experience reduced emotional wellbeing with those who struggle with stress directly related to their parenting role.

We previously reported that prenatal diagnosis of malformations is associated with increased parental psychological distress after birth compared to distress in parents with postnatal diagnosis. We have now extended our earlier study to include a long-term follow-up of mothers and fathers 9 years after birth. Psychological responses were measured by General Health Questionnaire (GHQ-28), State Anxiety Inventory (STAI-X1), and Impact of Event Scale (IES) in 118 mothers and 100 fathers of 124 children with malformations 0-7 days (T1), 6 weeks (T2), 6 months (T3), and 9 years postpartum (T4). At T4 we observed no significant differences in psychological responses comparing parents with and without prenatal foreknowledge of their child's malformation. At T4 30.2% and 27.8% of the parents reported clinically important psychological distress and clinically important state anxiety, respectively. Intrusive stress decreased from T1 to T3, but increased significantly from T3 to T4. At T4 25.6% of the parents reported severe intrusive stress, with a higher proportion among mothers than fathers (32.8% vs. 17.2%, P = 0.029). In the multivariate analysis, unemployment predicted clinically important psychological distress at T4, whereas, clinically important state anxiety at T4 was predicted by low educational level. This study shows that prenatal diagnosis is associated with significantly increased psychological distress in the acute postnatal phase. However, there was no long-term increase in psychological distress among parents with prenatal foreknowledge of their child's malformation. The significantly increased intrusive stress at 9-year follow-up might reflect long-term challenges related to having a child with a malformation.

Objective: To describe changes in consumption of different types of beverages from pre-pregnancy to early pregnancy, and to examine associations with maternal age, educational level and BMI. Design: Cross-sectional design. Participants answered an FFQ at inclusion into a randomized controlled trial, the Fit for Delivery (FFD) trial, in median gestational week 15 (range: 9-20), reporting current consumption and in retrospect how often they drank the different beverages pre-pregnancy. Setting: Eight local antenatal clinics in southern Norway from September 2009 to February 2013. Subjects: Five hundred and seventy-five healthy pregnant nulliparous women. Results: Pre-pregnancy, 27 % reported drinking alcohol at least once weekly, compared with none in early pregnancy (P < 0·001). The percentage of women drinking coffee (38 % v. 10 %, P < 0·001), sugar-sweetened beverages (10 % v. 6 %, P = 0·011) and artificially sweetened beverages (12 % v. 9 %, P = 0·001) at least daily decreased significantly from pre-pregnancy to early pregnancy, while the percentage of women who reported to drink water (85 % v. 92 %, P < 0·001), fruit juice (14 % v. 20 %, P = 0·001) and milk (37 % v. 42 %, P = 0·001) at least daily increased significantly. From pre-pregnancy to early pregnancy higher educated women reduced their consumption frequency of coffee significantly more than women with lower education. Older women reduced their consumption frequency of coffee and artificially sweetened beverages and increased their consumption frequency of fruit juice and milk significantly more than younger women. Conclusions: There is a significant change in beverage consumption from pre-pregnancy to early pregnancy among Norwegian nulliparous women.

Objective  Maternal and paternal psychological distress influence children’s development and health beyond the perinatal period. The aim of our study was to describe psychological health during a 5‐year period in parents of preschool children. Secondarily, we wanted to explore differences between mothers and fathers and identify predictors for increased psychological distress in parents. Design  Prospective cohort study. Setting  A county in Southern Norway 1998–2004. Population  One hundred and twenty‐three mothers and 112 fathers were candidates for the follow‐up study. Methods  Parental psychological responses were assessed using the General Health Questionnaire (GHQ‐28), State Anxiety Inventory‐X1 and Impact of Event Scale at 0–4 days, 6 weeks, 6 months and 5 years after delivery of a healthy child. Main outcome measure  Parental psychological distress defined by GHQ‐28 Likert sum score at 5‐year follow‐up. Results  Clinically important psychological distress (GHQ case score ≥ 6) was reported by more mothers (29%) than by fathers (11%) (P = 0.004). In multivariate analysis, psychological distress (GHQ‐28 Likert sum score) after 5 years was predicted by initial psychological distress, being single and low educational level in mothers, and unemployment and low quality of relationship with partner in fathers. Conclusions  Fathers reported significantly lower frequency of clinically important psychological distress and more stable scores than mothers throughout the period. The results indicate that selected psychometric screening may be warranted for parents with known psychosocial risk factors.

BackgroundA healthy diet is important for pregnancy outcome and the current and future health of woman and child. The aims of the study were to explore the changes from pre-pregnancy to early pregnancy in consumption of fruits and vegetables (FV), and to describe associations with maternal educational level, body mass index (BMI) and age.MethodsHealthy nulliparous women were included in the Norwegian Fit for Delivery (NFFD) trial from September 2009 to February 2013, recruited from eight antenatal clinics in southern Norway. At inclusion, in median gestational week 15 (range 9–20), 575 participants answered a food frequency questionnaire (FFQ) where they reported consumption of FV, both current intake and recollection of pre-pregnancy intake. Data were analysed using a linear mixed model.ResultsThe percentage of women consuming FV daily or more frequently in the following categories increased from pre-pregnancy to early pregnancy: vegetables on sandwiches (13 vs. 17%, p <0.01), other vegetables (11 vs. 14%, p = 0.01), fruits (apples, pears, oranges or bananas) (24 vs. 41%, p < 0.01), other fruits and berries (8 vs. 15%, p < 0.01) and fruits and vegetables as snacks (14 vs. 28%, p < 0.01). The percentage of women who reported at least daily consumption of vegetables with dinner (22% at both time points) was stable. A higher proportion of older women increased their consumption of vegetables and fruits as snacks from pre-pregnancy to early pregnancy compared to younger women (p=0.04).ConclusionsWe found an increase in the proportion of women consuming FV daily or more frequently from pre-pregnancy to early pregnancy.Trial registrationClinicalTrials.gov database, NCT01001689. https://clinicaltrials.gov/ct2/show/NCT01001689?term=NCT01001689&rank=1.

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.