Preventative psychological interventions to aid women after traumatic childbirth are needed. This proof-of-principle randomized controlled study evaluated whether the number of intrusive traumatic memories mothers experience after emergency caesarean section (ECS) could be reduced by a brief cognitive intervention. 56 women after ECS were randomized to one of two parallel groups in a 1:1 ratio: intervention (usual care plus cognitive task procedure) or control (usual care). The intervention group engaged in a visuospatial task (computer-game ‘Tetris’ via a handheld gaming device) for 15 min within six hours following their ECS. The primary outcome was the number of intrusive traumatic memories related to the ECS recorded in a diary for the week post-ECS. As predicted, compared with controls, the intervention group reported fewer intrusive traumatic memories (M = 4.77, SD = 10.71 vs. M = 9.22, SD = 10.69, d = 0.647 [95% CI: 0.106, 1.182]) over 1 week (intention-to-treat analyses, primary outcome). There was a trend towards reduced acute stress re-experiencing symptoms (d = 0.503 [95% CI: −0.032, 1.033]) after 1 week (intention-to-treat analyses). Times series analysis on daily intrusions data confirmed the predicted difference between groups. 72% of women rated the intervention “rather” to “extremely” acceptable. This represents a first step in the development of an early (and potentially universal) intervention to prevent postnatal posttraumatic stress symptoms that may benefit both mother and child.Clinical trial registrationClinicalTrials.gov, www.clinicaltrials.gov, NCT02502513.

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ObjectiveTo compare current mental health symptoms and infant bonding in parents whose infants survived perinatal asphyxia in the last 2 years with control parents and to investigate which sociodemographic, obstetric and neonatal variables correlated with parental mental health and infant bonding in the asphyxia group.DesignCross-sectional questionnaire survey of parents whose children were registered in the Swiss national Asphyxia and Cooling register and of control parents (Post-traumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Mother-to-Infant Bonding Scale).ResultsThe response rate for the asphyxia group was 46.5%. Compared with controls, mothers and fathers in the asphyxia group had a higher frequency of post-traumatic stress disorder (PTSD) symptoms (p<0.001). More mothers (n=28, 56%) had a symptom diagnosis of either full or partial PTSD than controls (n=54, 39%) (p=0.032). Similarly, more fathers (n=31, 51%) had a symptom diagnosis of either partial or full PTSD than controls (n=19, 33%) (p=0.034). Mothers reported poorer bonding with the infant (p=0.043) than controls. Having a trauma in the past was linked to more psychological distress in mothers (r=0.31 (95% CI 0.04 to 0.54)) and fathers (r=0.35 (95% CI 0.05 to 0.59)). For mothers, previous pregnancy was linked to poorer bonding (r=0.41 (95% CI 0.13 to 0.63)). In fathers, therapeutic hypothermia of the infant was related to less frequent PTSD symptoms (r=−0.37 (95% CI −0.61 to −0.06)) and past psychological difficulties (r=0.37 (95% CI 0.07 to 0.60)) to more psychological distress. A lower Apgar score was linked to poorer bonding (r=−0.38 (95% CI −0.64 to −0.05)).ConclusionsParents of infants hospitalised for perinatal asphyxia are more at risk of developing PTSD than control parents.

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Compared with full-terms, preterm individuals are more at risk from infancy to adulthood for developing internalizing symptoms. Early maternal interactive behavior, especially maternal sensitivity, has been found to be a resilience factor in the developmental outcome of preterm children. The present longitudinal study aimed at examining whether early interactive parenting behaviors have a long term impact on the internalizing symptoms of preterm-born young adolescents. A total sample of 36 very preterm and 22 full-term children participated in an 11-year follow-up study. Maternal interactive behavior was assessed during a mother-infant interaction when the infant was 18 months old. At 11 years, internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Hierarchical regression analyses revealed that the interaction between groups (preterm/full-term) and maternal sensitivity at 18 months significantly explained CBCL internalizing symptoms at 11 years (β = -0.526; p < 0.05). Specifically, although prematurity was related to internalizing problems, preterm children with higher maternal sensitivity did not differ from their full-term-born peers on the CBCL internalizing problems domain. These results suggest that maternal sensitivity is a long-term resilience factor preventing the development of internalizing problems at early adolescence in very preterm individuals.