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Anxiety, Depression and Stress in Pregnancy: Effects of Women
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Anxiety, Depression and Stress in Pregnancy: Effects of Women

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 69516

Special Issue Editors

Prof. Dr. Mariola Bidzan

E-Mail Website
Guest Editor
Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Jana Bażyńskiego 8, 80-309 Gdańsk, Poland
Interests: reproductive psychology; clinical psychology; health psychology; medical neuropsychology
Special Issues, Collections and Topics in MDPI journals
Dr. Łucja Bieleninik

E-Mail Website
Guest Editor
1. GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5838 Bergen, Norway
2. Institute of Psychology, University of Gdańsk, 80-309 Gdansk, Poland
Interests: clinical psychology; mental health; non-pharmacological interventions; psychosocial intervention; music therapy; clinical trials; RCTs; evidence-based medicine; systematic reviews and meta-analysis
Special Issues, Collections and Topics in MDPI journals
Dr. Karolina Lutkiewicz

E-Mail Website
Guest Editor
Faculty of Social Sciences, Institute of Psychology, University of Gdańsk, Jana Bażyńskiego 8, 80-309 Gdańsk, Poland
Interests: mental health; family psychology; reproductive psychology; well-being
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pregnancy is a time of very dynamic change to a woman's body function and mental well-being. This period is often portrayed as a time of great joy and happiness; however, this is not the case for all women. Some women are vulnerable to stress, a high level of anxiety and/or depression during pregnancy and in the postnatal period. Risk factors, including a high-risk pregnancy and pregnancy complications, e.g., biological, psychological or socio-cultural, can increase the symptoms of depression or anxiety and have adverse impacts on maternal and child outcomes.

For this Special Issue of IJERPH, we aim to present a collection of innovative, high-quality research studies, both theoretical and practical, on pregnancy in the context of women. This will focus on the difficulties and issues related to health and illness across pregnancy as well as in the post-delivery period. We cordially invite authors to submit original research, case studies and review articles that address major gaps in the existing body of research or provide an in-depth analysis of the present state of knowledge. Both qualitative and quantitative studies and reviews will be considered.

We would welcome your expertise and professional knowledge as an essential contribution to the quality of this Special Issue of IJERPH.

Prof. Mariola Bidzan
Dr. Łucja Bieleninik
Dr. Karolina Lutkiewicz
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anxiety
  • antenatal depression
  • pregnancy
  • high risk pregnancy
  • prenatal and postnatal stress
  • postpartum depression
  • transition to motherhood
  • postnatal care
  • prematurity

Published Papers (15 papers)

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11 pages, 354 KiB  
Article
Coping with Stress in Complicated Pregnancy and Gestational Weight Gain
by Agnieszka Rolińska, Anna Aftyka and Marzena Samardakiewicz
Int. J. Environ. Res. Public Health 2021, 18(19), 10493; https://doi.org/10.3390/ijerph181910493 - 6 Oct 2021
Cited by 2 | Viewed by 2162
Abstract
Maternal obesity is one of the leading health problems in the world. Excessive gestational weight gain (GWG) can lead to many complications during pregnancy, especially when it is accompanied by diabetes. Moreover, the risk of excessive GWG in pregnant women is significant, irrespective [...] Read more.
Maternal obesity is one of the leading health problems in the world. Excessive gestational weight gain (GWG) can lead to many complications during pregnancy, especially when it is accompanied by diabetes. Moreover, the risk of excessive GWG in pregnant women is significant, irrespective of prenatal counseling. Studies on this subject concerning coping with stress are lacking in the literature. The present work is aimed at evaluating the styles of coping with stress and their relation to GWG in pregnant women with gestational diabetes (GDM) for whom sudden adaptation to dietary management during this period can be challenging. It was indicated that women with GDM reported high stress related to potential maternal-fetal complications and worries about compliance with dietary management. The overall weight gain of participants in pregnancy was determined in connection to their prepregnancy body mass index (BMI) and classified based on the Institute of Medicine guidelines. A standardized psychological scale was used to assess coping styles. The results showed that almost half of the participants did not meet the Institute of Medicine recommendations for weight gain during pregnancy. There were significant correlations between the styles of coping with stress and the GWG. Additionally, low correlations were indicated between emotional, avoidant, task-oriented coping styles and the age of pregnant women with GDM. Regression analysis showed that the stress-coping style that focused on emotions was the most predictive of overall weight gain. There is a need for a better understanding of psychological barriers in achieving the recommended GWG and potential limitations in providers’ interventions, particularly for GDM. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
12 pages, 506 KiB  
Article
Trends of Perinatal Stress, Anxiety, and Depression and Their Prediction on Postpartum Depression
by Ching-Yu Cheng, Yu-Hua Chou, Chia-Hao Chang and Shwu-Ru Liou
Int. J. Environ. Res. Public Health 2021, 18(17), 9307; https://doi.org/10.3390/ijerph18179307 - 3 Sep 2021
Cited by 20 | Viewed by 4413
Abstract
Perinatal stress, anxiety, and depression impacts not only women but also their child(ren). The purpose of this longitudinal study is to explore trends of stress, anxiety, and depressive symptoms from pregnancy to postpartum and understand predictions of stress and anxiety on postpartum depression. [...] Read more.
Perinatal stress, anxiety, and depression impacts not only women but also their child(ren). The purpose of this longitudinal study is to explore trends of stress, anxiety, and depressive symptoms from pregnancy to postpartum and understand predictions of stress and anxiety on postpartum depression. One-hundred-fifty-six women at 23–28 weeks gestation (T1), 147 at 32–36 weeks gestation (T2), 129 at over 36 weeks gestation (T3), and 83 at postpartum (T4) completed study surveys. The Perceived Stress Scale, Center for Epidemiologic Studies Depression scale, and State-Trait Anxiety Inventory were used to measure stress, depressive symptoms, and anxiety. Descriptive statistics, Pearson and Spearman’s correlation, and Generalized Estimating Equation were applied to analyze the data. Results showed that levels of anxiety and depressive symptoms increased from 24 weeks gestation to postpartum, whereas stress levels decreased during pregnancy but increased in postpartum. Over half of women experienced anxiety symptoms, especially during late pregnancy and postpartum. Stress, anxiety, and depressive symptoms were inter-correlated. Notably, women at late pregnancy and postpartum were prone to stress, anxiety, and depression. Prenatal anxiety could predict postpartum depressive symptoms. Active assessment and management of stress, anxiety, and depression is needed and should begin from early pregnancy and continue until postpartum. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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20 pages, 760 KiB  
Article
Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant’s Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study
by Łucja Bieleninik, Karolina Lutkiewicz, Mariusz Cieślak, Joanna Preis-Orlikowska and Mariola Bidzan
Int. J. Environ. Res. Public Health 2021, 18(16), 8517; https://doi.org/10.3390/ijerph18168517 - 12 Aug 2021
Cited by 13 | Viewed by 3212
Abstract
(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. [...] Read more.
(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. Thus, the aim of this study was to evaluate the relationship between maternal postpartum bonding with maternal mental health, socio-demographical factors, and child’s characteristics. (2) Methods: A cross-sectional study design was used. In total, 72 women (a mean age of 31.44 years old) of preterm infants (mean gestational age = 33.54; range 24–36) filled out socio-demographic questionnaires, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS) 1–3 days post-delivery; (3) Results: The results analyses have shown positive correlations between the overall result of maternal postpartum bonding with stress (p < 0.01), maternal educational level (p < 0.01), maternal age (p < 0.05) and the number of children (p < 0.01). However, there were no significant relationships between other investigated variables. The results of linear regression have revelated the important role of the overall scores in experience of stress among mothers (explaining 49% of the variability). The mediating role of maternal stress on maternal postpartum bonding was not found. That relationship of maternal postpartum bonding and maternal stress was not moderated through socio-demographic variables. (4) Conclusions: In this study mothers of prematurely born children had a good level of Maternal-Infant bonding. Maternal stress was found to be a predictor of maternal postpartum bonding among the tested variables. Surprisingly, the study results did not show significant relationships between maternal postpartum bonding and maternal mental health (depression and anxiety). Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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14 pages, 546 KiB  
Article
Comparison of Early-Stage Mothers and Childless Women Seeking Pregnancy: Experienced Stress, Resilience and Satisfaction with Relationship with the Partner
by Alicja Malina and Dorota Suwalska-Barancewicz
Int. J. Environ. Res. Public Health 2021, 18(5), 2543; https://doi.org/10.3390/ijerph18052543 - 4 Mar 2021
Cited by 7 | Viewed by 2198
Abstract
Introduction: The birth of a child is a significant turning point in the life of a woman. It is a source of personal fulfilment, but also a great challenge. On the other hand, the inability to conceive a child in a natural way [...] Read more.
Introduction: The birth of a child is a significant turning point in the life of a woman. It is a source of personal fulfilment, but also a great challenge. On the other hand, the inability to conceive a child in a natural way results in a serious distortion of a woman’s psychic balance. Becoming a mother is an indicator of personal fulfilment and the source of social acceptation. Therefore, both becoming a mother and the inability to conceive a child in a natural way may be seen as stressful factors that impact a woman’s life. Aim of the study: The research project aimed to analyze the differences in stress, resilience and satisfaction with relationship and sexual satisfaction between early-stage mothers, i.e., women having a child and childless women seeking pregnancy. Sample: The study involved 80 women—40 mothers and 40 infertile women. The mean age of the mothers was 31.10 yrs (SD = 3.76) and of the childless women seeking pregnancy—31.48 yrs (SD = 3.35). Both groups were homogenous with regards to education, place of residence, the form and time of their relationship with partners. Method: The perceived stress was measured with the Perceived Stress Scale PSS—Polish adaptation by Juczyński and Ogińska-Bulik. Resilience was measured with Personal Adaptation Scale (LIRS-pl)—Polish adaptation by Malina, Pooley and Harms. The quality of the relationship was measured using the Quality of Relationship Inventory (QRI) adapted to Polish version by Suwalska-Barancewicz, Liberska and Izdebski and the sexual satisfaction was measured with the Sexual Satisfaction Questionnaire by Nomejko and Dolińska-Zygmunt. Results and conclusions: Statistical analyses indicate that the participating women differ in the level of perceived stress (higher among childless women seeking pregnancy; t = 2.721; p = 0.008), the depth/intensity of the relationship (higher among childless women seeking pregnancy; t = 2.376; p = 0.020) and conflict (higher among mothers; t = −2.829; p = 0.006). This research project proved that infertility and its consequences are not only negative. The research has shown that lower levels of relationship conflicts and greater commitment occur more frequently among infertile women than among mothers. Regardless of the observed differences in the studied sample, it is noteworthy that the compared groups are also similar to some extent. They neither differed in the level of personal resilience nor perceived support. Therefore, although the two experienced issues seem to be different, they may appear psychologically similar to some extent. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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15 pages, 361 KiB  
Article
Satisfaction with Life, Emotions, and Identity Processes in Polish First-Time Mothers and Fathers and Their Child’s Age
by Hanna Liberska and Monika Deja
Int. J. Environ. Res. Public Health 2021, 18(2), 799; https://doi.org/10.3390/ijerph18020799 - 19 Jan 2021
Cited by 2 | Viewed by 2009
Abstract
The experiences of women regarding conception, the birth of the first child, and care of an infant in the perinatal period have long attracted the attention of researchers, but the knowledge about the experiences of men entering the role of fathers for the [...] Read more.
The experiences of women regarding conception, the birth of the first child, and care of an infant in the perinatal period have long attracted the attention of researchers, but the knowledge about the experiences of men entering the role of fathers for the first time is still insufficient. The aim of the research was to identify the level of satisfaction with life, emotions and identity formation of first-time parents depending on the gender and age of the child. Seventy-five pairs of Polish first-time parents participated in the study. The research used the SUPIN scale (Polish adaptation of Positive and Negative Affect Schedule), the Satisfaction with Life Scale (SWLS), the Dimension of Identity Development Scale (DIDS), and a questionnaire prepared by the authors. On the basis of the conducted research, it can be concluded that there is a similarity of satisfaction with life, experienced emotions, and identity processes of first-time mothers and fathers, as well as the importance of the child’s age for the specificity of developmental changes in women and men. Understanding development changes which include identity, emotional functioning, and life satisfaction of first-time parents can provide bases for creating supporting programs in the case that problems in undertaking the role of a parent emerge. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
18 pages, 2193 KiB  
Article
Creative Music Therapy with Premature Infants and Their Parents: A Mixed-Method Pilot Study on Parents’ Anxiety, Stress and Depressive Symptoms and Parent–Infant Attachment
by Selina M. Kehl, Pearl La Marca-Ghaemmaghami, Marina Haller, Elisabeth Pichler-Stachl, Hans Ulrich Bucher, Dirk Bassler and Friederike B. Haslbeck
Int. J. Environ. Res. Public Health 2021, 18(1), 265; https://doi.org/10.3390/ijerph18010265 - 31 Dec 2020
Cited by 32 | Viewed by 9369
Abstract
Premature birth is stressful for infants and parents and can adversely affect the parent–infant dyad. This mixed-methods pilot study evaluates whether creative music therapy (CMT) can alleviate anxiety, stress, and depressive symptoms in parents and support the bonding process with their infant. Sixteen [...] Read more.
Premature birth is stressful for infants and parents and can adversely affect the parent–infant dyad. This mixed-methods pilot study evaluates whether creative music therapy (CMT) can alleviate anxiety, stress, and depressive symptoms in parents and support the bonding process with their infant. Sixteen parent couples were included. Ten couples were randomly allocated to the music therapy group (MTG) and six to the control group (CG). All couples completed psychological questionnaires measuring anxiety and depressive symptoms as well as an implicit measure of parent–infant attachment at two weeks postpartum (T1), at approximate neonatal intensive care unit (NICU) hospitalization halftime (T2), and two weeks after the infant had been discharged (T3). At T1 and T2, the parents additionally completed a questionnaire assessing the degree of stress they experienced at the NICU. Qualitative data were collected through a semi-structured, problem-centered interview with MTG parents at T3. The results of the quantitative analyses revealed reductions in anxiety levels from T1 to T2 (p = 0.002) as well as decreases in depressive symptoms from T2 to T3 (p = 0.022). No such changes were apparent in the CG. In fact, parental stress increased from T1 to T2 (p = 0.016). Significant increases in attachment across time were also observed within the MTG, but not in the CG. The qualitative inquiry confirmed that CMT can support the parent–infant relationship. Being in musical interaction evoked feelings of joy and relaxation in the parents and encouraged them to interact more profoundly with their infant. The results call for a more extensive powered follow-up study to further investigate CMT’s potential for parental well-being and parent–infant bonding. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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12 pages, 330 KiB  
Article
Body Acceptance by Pregnant Women and Their Attitudes toward Pregnancy and Maternity as Predictors of Prenatal Depression
by Hanna Przybyła-Basista, Elżbieta Kwiecińska and Michalina Ilska
Int. J. Environ. Res. Public Health 2020, 17(24), 9436; https://doi.org/10.3390/ijerph17249436 - 16 Dec 2020
Cited by 14 | Viewed by 3720
Abstract
Background: Depressive symptoms during pregnancy may cause unfavorable consequences for both the mother and the infant’s physiological and psychological health. Recent evidence indicates that body image plays an important role in prenatal depression. The present study’s main purpose was to investigate the level [...] Read more.
Background: Depressive symptoms during pregnancy may cause unfavorable consequences for both the mother and the infant’s physiological and psychological health. Recent evidence indicates that body image plays an important role in prenatal depression. The present study’s main purpose was to investigate the level of acceptance of physical appearance in pregnant women, their attitudes toward pregnancy and maternity, and some obstetric characteristics as significant predictors in the development of depression. Methods: A sample of 150 Polish pregnant women completed a set of self-report questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS), Attitudes toward Maternity and Pregnancy Questionnaire (PRE-MAMA), and the Body-Self Questionnaire (EA-BSQ). All participants also answered a brief sociodemographic and obstetric information questionnaire. Results: A hierarchical binary logistic regression was conducted to predict prenatal depression from selected obstetric variables (unplanned pregnancy, multiparity, and miscarriages) and psychological variables (appearance evaluation and positive or anxious attitudes toward pregnancy and maternity). It was found that higher levels of negative evaluation of appearance increased chances of depression in pregnant women by almost one-and-a-half. The analysis revealed that positive attitudes toward pregnancy and maternity were the most important protective factor for depression. Conclusions: The results confirmed the importance of dissatisfaction with body image during pregnancy as a predictor of the onset of prenatal depression. However, in clinical practice, this risk factor should be considered in combination with positive maternal attitudes, not separately. The implications for future studies and interventions in the field of prenatal depression are discussed in this work. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
10 pages, 313 KiB  
Article
Do Physical Activity and Personality Matter for Hair Cortisol Concentration and Self-Reported Stress in Pregnancy? A Pilot Cross-Sectional Study
by Dagmara Budnik-Przybylska, Radosław Laskowski, Paulina Pawlicka, Paulina Anikiej-Wiczenbach, Ariadna Łada-Maśko, Anna Szumilewicz, Franciszek Makurat, Jacek Przybylski, Hideaki Soya and Maria Kaźmierczak
Int. J. Environ. Res. Public Health 2020, 17(21), 8050; https://doi.org/10.3390/ijerph17218050 - 1 Nov 2020
Cited by 3 | Viewed by 2546
Abstract
Background: Physical activity reduces psychosocial stress in pregnant women. Stress levels might be self-reported (psychosocial) or measured with biomarkers, one of which is hair cortisol concentration (HCC). Additionally, personality has been associated with stress and physical activity. Methods: The first aim of our [...] Read more.
Background: Physical activity reduces psychosocial stress in pregnant women. Stress levels might be self-reported (psychosocial) or measured with biomarkers, one of which is hair cortisol concentration (HCC). Additionally, personality has been associated with stress and physical activity. Methods: The first aim of our study was to explore the differences in self-reported stress assessed by the Perceived Stress Scale (PSS) and in HCC with regard to physical activity level in pregnant (N = 29) and non-pregnant (N = 21) women. The second aim was to analyze the correlations among perceived stress, HCC, frequency of exercise and personality in the two groups separately. Results: There was a significant difference in frequency of exercise and self-reported stress between the two groups, with a lower level in pregnant women, but no differences in HCC and in personality were found. In the group of pregnant women, there was a significant negative correlation between HCC and frequency of exercise sessions, with the latter correlating positively with openness to experience. In the group of non-pregnant women, perceived stress negatively correlated with extraversion, agreeableness and emotional stability. HCC correlated negatively with conscientiousness. Conclusions: Our findings indicate the importance of physical activity programs dedicated to pregnant women for their life quality. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
12 pages, 321 KiB  
Article
Maternal–Infant Bonding and Its Relationships with Maternal Depressive Symptoms, Stress and Anxiety in the Early Postpartum Period in a Polish Sample
by Karolina Lutkiewicz, Łucja Bieleninik, Mariusz Cieślak and Mariola Bidzan
Int. J. Environ. Res. Public Health 2020, 17(15), 5427; https://doi.org/10.3390/ijerph17155427 - 28 Jul 2020
Cited by 57 | Viewed by 6980
Abstract
A large body of literature indicates that there is a relationship between maternal psychological well-being and the early maternal–infant bond. However, this relationship is not fully understood, due to the different theoretical frameworks of maternal–infant bonding and different data collections points. Thus, the [...] Read more.
A large body of literature indicates that there is a relationship between maternal psychological well-being and the early maternal–infant bond. However, this relationship is not fully understood, due to the different theoretical frameworks of maternal–infant bonding and different data collections points. Thus, the aim of this study was to examine the relationship between the maternal bond and the maternal psychological state including anxiety, stress, and maternal depressive symptoms. In this cohort study, 150 women who gave birth after 37 weeks of pregnancy completed the following self-reports 1–3 days post-delivery: Socio-demographic questionnaire, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS). The obtained results showed that the maternal level of stress, anxiety and postnatal depressive symptoms are significantly correlated with the maternal–infant bond in Polish mothers. In addition, regression analysis shows that postpartum depressive symptoms and maternal stress are significantly associated with the maternal–infant bonding process in the early postpartum period. This finding emphasizes the importance of identifying maternal mental state difficulties in the early postpartum period in order to provide interventions to help build healthy maternal–infant bonding. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
12 pages, 367 KiB  
Article
Social Support, Perceived Stress, Socio-Demographic Factors and Relationship Quality among Polish Mothers of Prematurely Born Children
by Karolina Lutkiewicz
Int. J. Environ. Res. Public Health 2020, 17(11), 3876; https://doi.org/10.3390/ijerph17113876 - 30 May 2020
Cited by 4 | Viewed by 2835
Abstract
Families with a prematurely born child may be exposed to various difficulties associated with prematurity. The study aimed to explain the relationship between social support and the quality of the partnership among mothers of children born prematurely. In addition, the coexistence of social [...] Read more.
Families with a prematurely born child may be exposed to various difficulties associated with prematurity. The study aimed to explain the relationship between social support and the quality of the partnership among mothers of children born prematurely. In addition, the coexistence of social support, perceived stress and social-demographical factors in the neonatal period was examined. The study group consisted of 260 mothers of preterm born children. Subjects completed The Socio-Demographic Questionnaire, The Social Support Sources Questionnaire (SSQ), The Dyadic Adjustment Scale (DAS) and The Perceived Stress Questionnaire (PSQ). In the second phase of the study, mothers completed The Dyadic Adjustment Scale (DAS). Person’s correlation coefficients were used to examine the variables and hierarchical linear regression analyses were performed to examine the relative contributions of social support on partnership relation quality. The study results showed that social support is positively related to partnership relationship quality among mothers of preterm born children. Social support measured in the neonatal period is not connected with relationship quality measured in the early childhood period. Social support is related with the father’s level of education and perceived stress corresponds with the level of parents’ education. The findings highlight the importance of expanding supportive resources for couples dealing with premature birth, especially among those with a lower level of education and lower financial status. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
14 pages, 516 KiB  
Article
Coping Styles in Pregnancy, Their Demographic and Psychological Influences, and Their Association with Postpartum Depression: A Longitudinal Study of Women in China
by Min Yu, Wenjie Gong, Beck Taylor, Yiyuan Cai and Dong (Roman) Xu
Int. J. Environ. Res. Public Health 2020, 17(10), 3654; https://doi.org/10.3390/ijerph17103654 - 22 May 2020
Cited by 15 | Viewed by 4189
Abstract
We aimed to investigate the coping styles of Chinese pregnant women, identify factors associated with coping and further explore the effect of coping during pregnancy on postpartum depression. A longitudinal study was performed from early pregnancy to six-week postpartum. A total of 1126 [...] Read more.
We aimed to investigate the coping styles of Chinese pregnant women, identify factors associated with coping and further explore the effect of coping during pregnancy on postpartum depression. A longitudinal study was performed from early pregnancy to six-week postpartum. A total of 1126 women were recruited by convenience sampling and participants who completed eight questionnaires at four time points were included (three self-developed questionnaires, Coping Style Questionnaire, Generalized Anxiety Disorder-7, Brief Resilience Scale, Rosenberg Self-esteem Scale, Edinburgh Postnatal Depression Scale) (n = 615). Linear regression analyses were used to identify the possible factors for coping and their association with postpartum depression. The mean scores of positive coping and negative coping were 2.03 and 1.21, respectively. Women with a higher educational level scored higher on both positive and negative coping in pregnancy. Resilience was associated with both positive and negative coping, while self-esteem only related to positive coping (p < 0.05). Postpartum depression was associated with both positive and negative coping (p < 0.05). The women in our study reported using positive coping styles more than negative coping antenatally. Positive and negative coping behaviors could be used simultaneously. Increasing self-esteem and resilience antenatally might promote more positive coping and further reduce the occurrence of postpartum depression. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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12 pages, 362 KiB  
Article
Attachment Styles, Various Maternal Representations and a Bond to a Baby
by Anna Zdolska-Wawrzkiewicz, Magdalena Chrzan-Dętkoś, Daria Pizuńska and Mariola Bidzan
Int. J. Environ. Res. Public Health 2020, 17(10), 3363; https://doi.org/10.3390/ijerph17103363 - 12 May 2020
Cited by 9 | Viewed by 3203
Abstract
(1) Background: The aim of this study was to assess the relationship between: (a) new mothers’ styles of attachment to their own mothers with their representation of self as a mother as well as with their representation of one’s mother as a [...] Read more.
(1) Background: The aim of this study was to assess the relationship between: (a) new mothers’ styles of attachment to their own mothers with their representation of self as a mother as well as with their representation of one’s mother as a mother, (b) new mothers’ representation of self as a mother with their representation of one’s own mother as a mother, and (c) their bonds with their children and their styles of attachment to their own mothers. (2) Methods: A total of 86 mothers were interviewed approximately six months postpartum. The Adjective Checklist, a modified version of the Experiences in Close Relationships, and the Postpartum Bonding Questionnaire were used in the study. (3) Results: Analysis revealed a statistically significant relationship between the new mothers’ styles of attachment to their own mothers and both their representation of self as a mother and their representation of one’s mother as a mother. The relationship between representation of self as a mother and representation of one’s mother as a mother was also statistically significant. No statistically significant relationship was observed between the style of attachment to one’s mother and the bond with one’s child six months postpartum. (4) Conclusions: A deeper understanding of the relationship between these variables may improve the help system directed at young mothers. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
13 pages, 1090 KiB  
Article
Hair Cortisol Concentrations as a Biomarker to Predict a Clinical Pregnancy Outcome after an IVF Cycle: A Pilot Feasibility Study
by Diana C. Santa-Cruz, Rafael A. Caparros-Gonzalez, Borja Romero-Gonzalez, Maria Isabel Peralta-Ramirez, Raquel Gonzalez-Perez and Juan Antonio García-Velasco
Int. J. Environ. Res. Public Health 2020, 17(9), 3020; https://doi.org/10.3390/ijerph17093020 - 27 Apr 2020
Cited by 7 | Viewed by 3142
Abstract
Our objective was to examine the feasibility of hair cortisol concentrations (HCC) as a biomarker to predict clinical pregnancy outcomes and investigate its potential associations with perceived anxiety, resilience, and depressive symptoms. A total of 43 participants were assessed using HCC, the state [...] Read more.
Our objective was to examine the feasibility of hair cortisol concentrations (HCC) as a biomarker to predict clinical pregnancy outcomes and investigate its potential associations with perceived anxiety, resilience, and depressive symptoms. A total of 43 participants were assessed using HCC, the state trait anxiety inventory (STAI), resilience scale (RS), and the depression subscale of the symptom checklist 90-R (SCL-90-R). Participants were approached at their second consultation with the reproductive endocrinologist (T1), before scheduling their IVF cycle, and then 12 weeks after (T2), at their post-transfer visit with the study coordinators, before the human chorionic gonadotropin (HCG) pregnancy test. The logistic regression model revealed that HCC at T2 predicted 46% of a positive pregnancy test [R2 = 0.46, (ß = 0.11, p < 0.05)]. Pregnant women had higher levels of resilience at T2 (M = 149.29; SD = 17.56) when compared with non-pregnant women at T2 (M = 119.96; SD = 21.71). Significant differences were found between both groups in depression at T2 (t = 3.13, p = 0.01) and resilience at T2 (t = −4.89, p = 0.01). HCC might be a promising biomarker to calculate the probability of pregnancy in women using assisted reproductive technologies (ART). Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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Review

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13 pages, 648 KiB  
Review
Hair Cortisol Concentrations as a Biological Marker of Maternal Prenatal Stress: A Systematic Review
by Mi-Young Kim, Go-Un Kim and Hae-Kyoung Son
Int. J. Environ. Res. Public Health 2020, 17(11), 4002; https://doi.org/10.3390/ijerph17114002 - 4 Jun 2020
Cited by 15 | Viewed by 2865
Abstract
Recently, biological markers of maternal prenatal stress, hair cortisol, along with saliva, blood, and urine cortisol, have received attention. However, it is necessary to validate measuring hair cortisol concentrations (HCC) as a biomarker of perceived stress among healthy and high-risk pregnant women. This [...] Read more.
Recently, biological markers of maternal prenatal stress, hair cortisol, along with saliva, blood, and urine cortisol, have received attention. However, it is necessary to validate measuring hair cortisol concentrations (HCC) as a biomarker of perceived stress among healthy and high-risk pregnant women. This study aimed to confirm the correlation between HCC and the perceived stress of pregnant women over 18 years of age. In this systematic review, we used various search engines to extract relevant articles using specific keywords related to pregnancy, hair cortisol, and psychological stress. Four out of 3639 studies met the inclusion criteria. We conducted a quality assessment with the help of three independent reviewers using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The correlation between HCC and perceived stress was confirmed in one study. There was only one study on hair washing, shampoo, conditioner, and hair structure that could affect hair samples. In four studies, hair samples differed in length, methods of storage, and laboratory analysis. The review was limited to confirming the relationship between HCC and perceived stress in pregnant women based on the current evidence. Studies on hair cortisol need regulated and standardized methods for collection, storage, and analysis of hair samples. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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42 pages, 3215 KiB  
Review
The Effect of Maternal Depression on Infant Attachment: A Systematic Review
by Andrzej Śliwerski, Karolina Kossakowska, Karolina Jarecka, Julita Świtalska and Eleonora Bielawska-Batorowicz
Int. J. Environ. Res. Public Health 2020, 17(8), 2675; https://doi.org/10.3390/ijerph17082675 - 14 Apr 2020
Cited by 74 | Viewed by 14791
Abstract
Aims and objectives: The aim of this systematic review was to summarize the key findings of empirical studies assessing the influence of maternal depression on child attachment security measured before 24 months after birth. Method: The study followed the Preferred Reporting [...] Read more.
Aims and objectives: The aim of this systematic review was to summarize the key findings of empirical studies assessing the influence of maternal depression on child attachment security measured before 24 months after birth. Method: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was conducted on the EBSCO (Academic Search Complete; Health Source: Nursing/Academic Edition; MEDLINE; PsycARTICLES) and PubMed databases, with infant attachment AND depression as search terms with Boolean operators. Study design or sample size did not affect inclusion. After screening, 29 of the 1510 unique publications originally identified were included in the review. Results: The studies reveal an equivocal association between maternal depression and child attachment security. Our findings indicate that depression had a significant influence on the attachment style almost only when diagnosed by structured interview: Depression measured by self-descriptive questionnaires was unrelated to attachment style. Furthermore, postpartum depression was found to be significant only when measured up to six months after childbirth. Conclusion: The relationship between maternal depression and infant attachment is both complex and dynamic, and the possible negative effects of depression might be compensated by maternal involvement in childcare. Therefore, further studies in this area should employ a reliable methodology for diagnosing depression and a suitable time point for measuring it; they should also adopt a multifactorial and prospective approach. It is important to note that breastfeeding/formula feeding was omitted as a factor in the majority of studies. Full article
(This article belongs to the Special Issue Anxiety, Depression and Stress in Pregnancy: Effects of Women)
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