Maternal Psychological Distress and Mother–Infant Relationship: Multiple-Birth Versus Singleton Preterm Infants

Gondwe, Kaboni Whitney; Yang, Qing; White‐Traut, Rosemary; Holditch‐Davis, Diane

doi:10.1891/0730-0832.36.2.77

Cited by 12 publications

(22 citation statements)

References 30 publications

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“…In addition, they also reported emotional stress more frequently compared with term group parents. Similar experiences have been reported in earlier studies [ 2 , 3 ], especially in cases where the preterm infant was admitted to the ICU [ 5 ]. In our study, parents with term infants expressed positive emotions more frequently than did those in the preterm group.…”

Section: Discussionsupporting

confidence: 87%

“…These are more prominent for parents of preterm infants than for parents of term infants [ 2 ]. An assessment of maternal psychological distress in singleton versus multiple-birth preterm infants found that mothers with multiple births had greater posttraumatic stress symptoms, anxiety at discharge, and depressive symptoms at 6 months as compared to mothers of singletons [ 3 ]. In a follow-up clinic evaluation of parents and their preterm infants, many reported parental concerns about medical and developmental outcomes that were unsupported by their child’s diagnosis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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A Chatbot to Engage Parents of Preterm and Term Infants on Parental Stress, Parental Sleep, and Infant Feeding: Usability and Feasibility Study

Wong¹,

Foussat²,

Ting³

et al. 2021

JMIR Pediatr Parent

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Background Parents commonly experience anxiety, worry, and psychological distress in caring for newborn infants, particularly those born preterm. Web-based therapist services may offer greater accessibility and timely psychological support for parents but are nevertheless labor intensive due to their interactive nature. Chatbots that simulate humanlike conversations show promise for such interactive applications. Objective The aim of this study is to explore the usability and feasibility of chatbot technology for gathering real-life conversation data on stress, sleep, and infant feeding from parents with newborn infants and to investigate differences between the experiences of parents with preterm and term infants. Methods Parents aged ≥21 years with infants aged ≤6 months were enrolled from November 2018 to March 2019. Three chatbot scripts (stress, sleep, feeding) were developed to capture conversations with parents via their mobile devices. Parents completed a chatbot usability questionnaire upon study completion. Responses to closed-ended questions and manually coded open-ended responses were summarized descriptively. Open-ended responses were analyzed using the latent Dirichlet allocation method to uncover semantic topics. Results Of 45 enrolled participants (20 preterm, 25 term), 26 completed the study. Parents rated the chatbot as “easy” to use (mean 4.08, SD 0.74; 1=very difficult, 5=very easy) and were “satisfied” (mean 3.81, SD 0.90; 1=very dissatisfied, 5 very satisfied). Of 45 enrolled parents, those with preterm infants reported emotional stress more frequently than did parents of term infants (33 vs 24 occasions). Parents generally reported satisfactory sleep quality. The preterm group reported feeding problems more frequently than did the term group (8 vs 2 occasions). In stress domain conversations, topics linked to “discomfort” and “tiredness” were more prevalent in preterm group conversations, whereas the topic of “positive feelings” occurred more frequently in the term group conversations. Interestingly, feeding-related topics dominated the content of sleep domain conversations, suggesting that frequent or irregular feeding may affect parents’ ability to get adequate sleep or rest. Conclusions The chatbot was successfully used to collect real-time conversation data on stress, sleep, and infant feeding from a group of 45 parents. In their chatbot conversations, term group parents frequently expressed positive emotions, whereas preterm group parents frequently expressed physical discomfort and tiredness, as well as emotional stress. Overall, parents who completed the study gave positive feedback on their user experience with the chatbot as a tool to express their thoughts and concerns. Trial Registration ClinicalTrials.gov NCT03630679; https://clinicaltrials.gov/ct2/show/NCT03630679

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

A Chatbot to Engage Parents of Preterm and Term Infants on Parental Stress, Parental Sleep, and Infant Feeding: Usability and Feasibility Study

Wong¹,

Foussat²,

Ting³

et al. 2021

JMIR Pediatr Parent

View full text Add to dashboard Cite

show abstract

“…Manual backward elimination was used to select the final model, with significance level for retaining the covariates in the final model set at .1. The multiple birth, intervention, and study site variables were considered in model selection process as possible controls, because they had shown effects in previous analyses (Gondwe, Yang, White‐Traut, & Holditch‐Davis, ; Holditch‐Davis et al, ). Analyses were performed using Statistical Analysis Software (SAS) version 9.3.…”

Section: Methodsmentioning

confidence: 99%

The role of sociodemographic factors in maternal psychological distress and mother‐preterm infant interactions

Gondwe

White‐Traut

Brandon

et al. 2017

Research in Nursing & Health

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Preterm birth has been associated with greater psychological distress and less positive mother infant interactions than were experienced by mothers of full-term infants. Maternal and infant sociodemographic factors have also shown a strong association with psychological distress and the mother-infant relationship. However, findings on their effects over time are limited. In this longitudinal analysis, we explored the relationship of maternal and infant sociodemographic variables (maternal age, maternal education, marital status, being on social assistance, maternal race, infant birth weight, and infant gender) to maternal psychological distress (depressive, posttraumatic stress, anxiety, parenting stress symptoms, and maternal worry about child’s health) through 12 months corrected age for prematurity, and on the home environment, and mother-infant interactions through 6 months corrected age for prematurity. We also explored differences related to maternal obstetrical characteristics (gestational age at birth, parity, mode of delivery, and multiple birth) and severity of infant conditions (Apgar scores, need for mechanical ventilation, and infant medical complications). Although the relationship of maternal and infant characteristics with these outcomes did not change over time, psychological distress differed based on marital status, maternal education, infant gender, and infant medical complications. Older mothers provided more a positive home environment. Mother-infant interactions differed by maternal age, being on public assistance, maternal race, infant gender, and infant medical complications. More longitudinal research is needed to better understand these effects over time in order to identify and support at-risk mothers.

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“…The slope of fetal growth in twin pregnancies is lower than that in a singleton pregnancy, and LBW is known to be a complication in 50% of twin pregnancy cases [ 21 ]. Neonates born from multiple pregnancies undergo many socioeconomic, educational, and emotional problems [ 22 , 23 ]. Therefore, since the impact on future healthcare could differ between singleton and multiple pregnancies when the effects of LBW on healthcare are considered, it might be better to exclude multiple pregnancy cases from such analyses.…”

Section: Discussionmentioning

confidence: 99%

What are the causes for low birthweight in Japan? A single hospital-based study

et al. 2021

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Low-birthweight (LBW; <2,500 g) babies are at a higher risk of poor educational achievement, disability, and metabolic diseases than normal-birthweight babies in the future. However, reliable data on factors that contribute to LBW have not been considered previously. Therefore, we aimed to examine the distribution of the causes for LBW. A retrospective review of cases involving 4,224 babies whose mothers underwent perinatal care at Keio University Hospital between 2013 and 2019 was conducted. The LBW incidence was 24% (1,028 babies). Of the 1,028 LBW babies, 231 babies were from multiple pregnancies. Of the 797 singleton LBW babies, 518 (65%) were born preterm. Obstetric complications in women with preterm LBW babies included premature rupture of membrane or labor onset (31%), hypertensive disorders of pregnancy (HDP, 64%), fetal growth restriction (24%), non-reassuring fetal status (14%), and placental previa/vasa previa (8%). Of the 279 term LBW babies, 109 (39%) were small for gestational age. Multiple logistic regression analyses revealed the following factors as LBW risk factors in term neonates: low pre-pregnancy maternal weight, inadequate gestational weight gain, birth at 37 gestational weeks, HDP, anemia during pregnancy, female sex, and neonatal congenital anomalies. HDP was an LBW risk factor not only in preterm births but also in term births. Our results suggest that both modifiable and non-modifiable factors are causes for LBW. It may be appropriate to consider a heterogeneous rather than a simple classification of LBW and to evaluate future health risks based on contributing factors.

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Maternal Psychological Distress and Mother–Infant Relationship: Multiple-Birth Versus Singleton Preterm Infants

Cited by 12 publications

References 30 publications

A Chatbot to Engage Parents of Preterm and Term Infants on Parental Stress, Parental Sleep, and Infant Feeding: Usability and Feasibility Study

A Chatbot to Engage Parents of Preterm and Term Infants on Parental Stress, Parental Sleep, and Infant Feeding: Usability and Feasibility Study

The role of sociodemographic factors in maternal psychological distress and mother‐preterm infant interactions

What are the causes for low birthweight in Japan? A single hospital-based study

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