The relationship between prematurity and maternal mental health during the first postpartum year

Worrall, Semra; Silverio, Sergio A.; Fallon, Victoria

doi:10.1016/j.jnn.2022.10.002

Cited by 3 publications

(3 citation statements)

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“…We must also give greater energy to and focus on those families who find care hard to access ( 46 ); experience high levels of social complexity, inequality, and deprivation ( 47 ); may have a rooted distrust for the NHS and wider social care systems ( 48 ); or are generally underserved by the health and care system ( 49 ). In doing so, we must integrate psychological support across the healthcare systems linked to maternal and child health, especially for families who experience pregnancy losses ( 50 ), those whose babies are born premature or become ill ( 51 ), or whose babies die ( 30 , 52 ), as these parents and families require additional psychological support as they access other parts of the healthcare system such as Neonatal Intensive Care Units [NICU; ( 30 )] or perinatal bereavement care services ( 53 ).…”

Section: Discussion Of Recommendationsmentioning

confidence: 99%

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Jackson,

Greenfield,

Payne

et al. 2024

Front. Glob. Womens Health

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IntroductionThe COVID-19 pandemic posed a significant lifecourse rupture, not least to those who had specific physical vulnerabilities to the virus, but also to those who were suffering with mental ill health. Women and birthing people who were pregnant, experienced a perinatal bereavement, or were in the first post-partum year (i.e., perinatal) were exposed to a number of risk factors for mental ill health, including alterations to the way in which their perinatal care was delivered.MethodsA consensus statement was derived from a cross-disciplinary collaboration of experts, whereby evidence from collaborative work on perinatal mental health during the COVID-19 pandemic was synthesised, and priorities were established as recommendations for research, healthcare practice, and policy.ResultsThe synthesis of research focused on the effect of the COVID-19 pandemic on perinatal health outcomes and care practices led to three immediate recommendations: what to retain, what to reinstate, and what to remove from perinatal mental healthcare provision. Longer-term recommendations for action were also made, categorised as follows: Equity and Relational Healthcare; Parity of Esteem in Mental and Physical Healthcare with an Emphasis on Specialist Perinatal Services; and Horizon Scanning for Perinatal Mental Health Research, Policy, & Practice.DiscussionThe evidence base on the effect of the pandemic on perinatal mental health is growing. This consensus statement synthesises said evidence and makes recommendations for a post-pandemic recovery and re-build of perinatal mental health services and care provision.

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Section: Discussion Of Recommendationsmentioning

confidence: 99%

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Jackson,

Greenfield,

Payne

et al. 2024

Front. Glob. Womens Health

Self Cite

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“…Mothers of extremely premature infants have consistently poorer mental health outcomes compared to mothers who have later premature infants (9), including feelings of hypervigilance and panic, through NICU stays and to the transition home (10,11). More broadly, maternal depression (12), posttraumatic stress disorder (13), and anxiety (14,15) have been linked to the unexpectedness of the birth and loss of control regarding the infant's health in the context of preterm birth. A recent systematic review estimated that, at one month after birth, prevalence rates of anxiety and posttraumatic stress were 41.9% and 39.9%, respectively, among parents with infants admitted to the neonatal unit (16).…”

Section: Introductionmentioning

confidence: 99%

“…Mothers of premature infants are more likely to develop symptoms of anxiety, particularly in relation to NICU stays (14,20). Although there is increasing research into the relationship between a premature birth and the onset of PPA (15), the use of measures designed for general adult populations persists (21,22), despite evidence suggesting that they are inappropriate for use during the postpartum period (23).…”

Section: Introductionmentioning

confidence: 99%

Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress

Worrall,

Christiansen,

Khalil

et al. 2024

Front. Psychiatry

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IntroductionIt is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU.Materials and methodsMothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale – Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU.ResultsFor the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p < 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p < 0.001) as measured by the PSS:NICU.ConclusionsOur findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.

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Measurement invariance analysis of the Postpartum Specific Anxiety Scale - Research Short Form in mothers of premature and term infants

Worrall,

Christiansen,

Khalil

et al. 2024

BMC Res Notes

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Objective Mothers of premature infants are more likely to develop anxiety during the first postpartum year than mothers of term infants. However, commonly used measures of anxiety were developed for general adult populations and may produce spurious, over-inflated scores when used in a postpartum context. Although perinatal-specific tools such as the Postpartum Specific Anxiety Scale [PSAS] offer a promising alternative form of measurement, it is not clear whether the measure performs similarly in mothers of premature infants as it does in mothers of term infants. The objective of the current study was to identify whether items on the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) are being interpreted in the same manner in mothers of term infants and mothers of premature infants. Mothers (N = 320) participated in an international on-line survey between February 2022 and March 2023 (n = 160 mothers of premature infants, n = 160 mothers of term infants) where they completed the PSAS-RSF. Data were analysed using a measurement invariance analysis to assess whether constructs of the PSAS-RSF are performing in a similar manner across the two groups. Results Whilst the PSAS-RSF achieved configural invariance and so retains its four-factor structure, metric invariance was not reached and so items are being interpreted differently in mothers of premature infants. Items concerning infant-separation, finance, and anxieties surrounding infant health are potentially problematic. Future research must now modify the PSAS-RSF for specific use in mothers of premature infants, to ensure measurement of anxiety in this population is valid.

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The relationship between prematurity and maternal mental health during the first postpartum year

Cited by 3 publications

References 46 publications

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

A consensus statement on perinatal mental health during the COVID-19 pandemic and recommendations for post-pandemic recovery and re-build

Associations between prematurity, postpartum anxiety, neonatal intensive care unit admission, and stress

Measurement invariance analysis of the Postpartum Specific Anxiety Scale - Research Short Form in mothers of premature and term infants

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