BackgroundInfant development is adversely affected in the context of postnatal depression. This relationship may be mediated by both the nature of early mother-infant interactions and the quality of the home environment.AimsTo establish the usefulness of the Global Ratings Scales of Mother–Infant Interaction and the Infant–Toddler version of the Home Observation for the Measurement of the Environment (IT–HOME), and to test expected associations of the measures with characteristics of the social context and with major or minor depression.MethodBoth assessments were administered postnatally in four European centres; 144 mothers were assessed with the Global Ratings Scales and 114 with the IT–HOME. Affective disorder was assessed by means of the Structured Clinical Interview for DSM–IV Disorders.ResultsAnalyses of mother–infant interaction indicated no main effect for depression but maternal sensitivity to infant behaviour was associated with better infant communication, especially for women who were not depressed. Poor overall emotional support also reduced sensitivity scores. Poor support was also related to poorer IT–HOME scores, but there was no effect of depression.ConclusionsThe Global Ratings Scales were effectively applied but there was less evidence of the usefulness of the IT–HOME.
Early mother-infant interactions are characterised by periods of synchronous interaction that are interrupted by periods of mismatch; the experience of such mismatches and their subsequent repair is held to facilitate the development of infant self-regulatory capacities (Tronick, Als, Adamson, Wise, & Brazelton, 1978). Infant responding to such interactive challenge is assumed to be a function of both maternal behaviour and pre-existing infant characteristics. However, the latter has received relatively little attention. In a prospective longitudinal study of a sample comprising high and low adversity dyads (n=122), we examined the contributions of both maternal sensitivity and neonatal irritability to infant behavioural and physiological responding to the interactive challenge of the Still Face paradigm. Results indicated that higher levels of maternal sensitivity were associated with more regulated infant behaviour during the Still Face paradigm. Neonatal irritability also predicted poorer behavioural and heart rate recovery following the Still Face challenge. Furthermore, there was an interaction such that irritable infants with insensitive mothers showed the worst behavioural outcomes. The findings highlight the importance of the interplay between maternal and infant characteristics in determining dyadic responding.
Aim: To explore obese women's perceptions of obesity as a risk factor in pregnancy and their experiences of NHS maternity care. Methods: Open-ended, semi-structured interviews were used to gain an in-depth understanding of participants’ experiences. Eight women were interviewed in their own homes in Edinburgh and the surrounding area. All had a pregnancy of beyond 34 weeks’ gestation and had a body mass index (BMI) greater than 40 kg/m2 at pregnancy booking. Findings: Participants were aware of obesity as a risk factor in pregnancy, but this awareness had developed only during the index pregnancy. Some participants felt the significant risks posed by obesity in pregnancy had not been explained adequately to them, both prior to and early in the pregnancy. This had caused significant anxiety in some cases. Conclusions: There is a need for opportunistic health promotion aimed at disseminating information about the risks of obesity in pregnancy to overweight and obese women of childbearing age. In addition, midwives need guidance in discussing this sensitive issue with women, in order to promote open communication and effective clinical care.
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