Maternal Perinatal Mental Health and Multiple Births: Implications for Practice

Fisher, Jane; Stocky, Andrew

doi:10.1375/136905203322686509

Cited by 60 publications

(33 citation statements)

References 39 publications

(9 reference statements)

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“…Thus, multiple pregnant women might be more susceptible to postpartum depression than singleton mothers. This was consistent with previous studies [25]. As mentioned in our results, premature infants usually had low birth weight and poor physique.…”

Section: Discussionsupporting

confidence: 94%

Risk factors for postpartum depression among Chinese women: path model analysis

Liu

Yan

Gao

et al. 2017

BMC Pregnancy Childbirth

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BackgroundPostpartum depression causes harm to both mothers and infants. The purpose of this study was to find out several potential risk factors, and to identify the intrinsic interrelationships between factors and postpartum depression by constructing a path model. The results of this study may help to control the increasing incidence of maternal postpartum depression.MethodsThe study was based on a sample of mothers from a cross-sectional study which was set up at 4 weeks after a mother had childbirth and was conducted in three streets at Kaifu District of Changsha in Hunan province from January to December 2015. Questionnaires were distributed to subjects who responded to questions concerning factors related to pregnancy, delivery and infants within 4 weeks after childbirth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure postpartum depression. Chi-square test was used to detect significant differences between non-postpartum depression group and postpartum depression group. A path model was constructed to explore the interrelationships between variables, and to verify the relationships between variables and postpartum depression.ResultsThe proportion of maternal postpartum depression was 6.7%. Univariate analysis showed that there were significant differences between non-postpartum depression group and postpartum depression group (all P-values <0.05) on the part of maternal age, parity, frequent exposure to mobile phone during pregnancy, gestational hypertensive disorders, fetus number, premature delivery, birth weight, initiation of breastfeeding, mode of feeding, infant illness within 4 weeks after delivery and infant weight at 4 weeks. Path analysis results showed that the final model could be fitted well with sample data (P = 0.687, CMIN/DF = 0.824, NFI = 0.992, RFI = 0.982, IFI = 1.002, TLI =1.004, CFI = 1.000 and RMSEA < 0.001). Frequent exposure to mobile phone during pregnancy, maternal age and gestational hypertensive disorders had both direct and indirect effects on postpartum depression. Mode of feeding and infant weight at 4 weeks, which was the most total effect on postpartum depression, had only a direct impact on postpartum depression. Fetus number, premature delivery, initiation of breastfeeding and birth weight had only an indirect influence on postpartum depression.ConclusionThe findings of this study suggest that constructing a path analysis model could identify potential factors and explore the potential interrelations between factors and postpartum depression. It is an effective way to prevent maternal postpartum depression by taking appropriate intervention measures and carrying out health education for pregnant women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1320-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 94%

Risk factors for postpartum depression among Chinese women: path model analysis

Liu

Yan

Gao

et al. 2017

BMC Pregnancy Childbirth

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“…Some research has suggested that newborn twins are more likely than multiples to have difficult temperaments (i.e., high reactivity, low adaptability, and more negative mood; Hay et al 1990). Other factors that have been proposed as contributing to worse mental health outcomes among mothers of multiples include more perinatal medical complications and longer duration hospital stays before and/or after childbirth, greater difficulty establishing breastfeeding, and a more difficult physical recovery (Fisher and Stocky 2003). However, in the absence of additional research demonstrating an association between multiple births and poorer postpartum mental health, one can only speculate on such mediational relationships.…”

Section: Discussionmentioning

confidence: 99%

“…Further, there is evidence that, at least among IVF couples, providers are more likely to discuss the risks associated with higher-order multiples but rarely discuss the challenges of having twins (Ellison et al 2005; Porter and Bhattacharya 2005). While providers may have become more likely to discuss the logistical and emotional risks of having multiples since these studies were published, typical prenatal care for women expecting multiples likely still does not follow expert recommendations (Fisher and Stocky 2003). Regardless of the reasons for the discrepancy, findings to date suggest that the anticipation of having twins or higher order multiples may not be as emotionally disruptive as the realities of parenting young multiples.…”

Section: Discussionmentioning

confidence: 99%

“…However, to our knowledge, no comprehensive literature review has been published that examines mental health outcomes in parents of multiples; only two related reviews exist, focusing more narrowly on risk for postpartum depression (PPD) in women who conceived twins as a result of assisted reproductive technology (ART; Ross et al 2011) and mental health in parents of twins conceived via ART (Vilska and Unkila-Kallio 2010). Although results from six qualitative studies regarding the experience of parenting twins were summarized over a decade ago (Beck 2002), and some clinical recommendations have been proposed (e.g., Fisher and Stocky 2003), to our knowledge, a review of quantitative studies has not been published to date. With this background in mind, we conducted a systematic review of the current literature on parental mental health associated with multiple gestation pregnancies and following the birth of multiples.…”

Section: Introductionmentioning

confidence: 99%

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Raising multiples: mental health of mothers and fathers in early parenthood

Wenze

Battle

Tezanos

2014

Arch Womens Ment Health

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The rate of twin and higher-order gestation births has risen dramatically in recent decades in the United States as well as other Western countries. Although the obstetrical and neonatal risks of multiple gestation pregnancies are well-documented, much less is known regarding the mental health impact on parents of multiples during the perinatal and early parenthood period. Given that parents of multiples face greater functional demands, as well as other pressures (financial, medical) this population may be at risk for heightened distress. We conducted a systematic review of quantitative, English language studies that assessed mental health outcomes of parents of multiples during pregnancy, in the first postpartum year, and in the period of early parenthood, including depression, anxiety, stress, and related constructs. Twenty-seven articles published between 1989 and 2014 met selection criteria and were included in the review. Studies utilized a wide range of methods and outcome constructs, often making comparisons difficult. Although some studies found no differences, most investigations that compared mental health outcomes in parents of multiples versus parents of singletons found that parents of multiples experience heightened symptoms of depression, anxiety, and parenting stress. We discuss gaps in the existing body of literature on parental mental health related to multiple gestation birth and conclude by discussing the need for novel intervention strategies to meet the needs of this growing population. Parents of multiples may experience worse mental health outcomes than parents of singletons. More research is needed, and future work should explore potential treatment and support options.

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“…Second, however, it is possible that this low rate of distress is reflecting an almost elated mood, in which the pregnant state and family formation achieved after a long period of anticipation and via intrusive and disruptive interventions are somewhat idealized (50). Evidence for this interpretation is the remarkably low rates of mood disturbance, high ratings of general health, intense and sustained protective and affectionate preoccupation with the fetus, and perception of the marital relationship as exceptionally affectionate, sensitive, and supportive.…”

Section: Discussionmentioning

confidence: 99%