Twin Pregnancies: Evaluation of Major Depression, Stress, and Social Support

Abstract

Background: Twin pregnancies are at increased physiological and psychosocial risks. Objective: To investigate the prevalence of major depression in twin pregnancies and correlate with stress and social support. Method: The study included 51 pregnant women under specialized prenatal care who were evaluated by a Portuguese version of the semi-structured questionnaire Primary Care Evaluation of Mental Disorders (PRIME-MD) for Major Depression, and the Prenatal Psychosocial Profile (PPP) for evaluation of stress and social support. Results: Major depression was found in 33.3% of pregnant women, and prevailing symptoms were fatigue or loss of energy (100%), insomnia or hypersomnia (82.4%), changes in appetite (82.4%), decreased interest in daily activities (82.4%), and psychomotor agitation or retardation (82.4%). Among pregnant women who were diagnosed depressive, 76.5% also had a high level of stress and 47.1% complained about lack of social support. Statistical significance was found when correlating depression with perception of negative aspects of having twins and belief in significant body changes during pregnancy (p = .005 and .03, respectively). Marital status, occupation, and pregnancy planning were not significantly associated with the diagnosis of depression. Conclusion: Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support. A multidisciplinary approach in these cases is fundamental to minimize further risks and complications.

Understanding the lives of multiple-birth families: Listening to the voices of parents and professionals

“…Systematic review shows that that parents of multiples experience heightened symptoms of depression, anxiety, and parental stress that parents of singletons. Major depression occurs in one-third of pregnant women expecting twins and is associated with higher levels of stress and lack of social support [39]. The couple's relationship has been found to be one of the most important resources as experienced by the parents of multiples [8] and both family care workers and parents felt it was important to talk about the relationship [9,31].…”

“…She described the situation in terms of themes such as power drain, pausing one's own life, striving to relax, and resuming one's own life. Major depression occurs in one-third of pregnant women expecting twins [39]. Such mothers have been shown to have significantly higher levels of parenting stress and depression than mothers of singletons, and were significantly more likely to find parenting difficult and significantly less likely to obtain pleasure from their child [40,41].…”

Prenatal Attachment in Twin Pregnancy

“…Different researches tried to evaluate the association between the presence of mood disorders and stress in parents and twin pregnancies. Researchers that focused on parental experience associated to twin pregnancy that occurs both naturally or with ART investigated either the joint experience of mothers and fathers [9][10][11][12] or of mothers alone [13][14][15][16]. It was observed that the risks usually associated to twin pregnancy lead to higher level of stress [17] and seemed to increase the incidence of depression and anxiety in parents of twins and especially in mothers [6, 9-11, 16, 18].…”

“…It was observed that the risks usually associated to twin pregnancy lead to higher level of stress [17] and seemed to increase the incidence of depression and anxiety in parents of twins and especially in mothers [6, 9-11, 16, 18]. In addition, it was also observed that the presence of medical risk as well as psychological suffering in mothers during twin pregnancy is generally associated to higher level of fatigue, loss of energy, depressed mood and feelings of worthlessness and guilt [14].…”

Optimizing the number of embryos to transfer on day 5: two should be the limit

“…In addition, stress generated to parents due to the emotional, economic and social impact that entails a sudden increase in the family size must be considered (Benute et al, 2013; Ellison & Hall, 2003). …”