Relation Between Perceived Stress, Social Support, and Coping Strategies and Maternal Well-Being: A Review of the Literature
a Department of Midwifery , University of Applied Sciences Western Switzerland , Geneva , Switzerland. Women & Health
(Impact Factor: 1.05).
02/2013; 53(1):74-99. DOI: 10.1080/03630242.2012.732681
The objective of this work was to review published articles on the impact of perinatal stress on mothers' medium- or long-term psychological health and the efficacy of coping strategies, to determine if social support plays a role in the interaction between birth events and mothers' psychological experiences, and to identify the tools used for these measurements. MEDLINE, PsycINFO, and CINAHL databases were searched for English and French language articles from 2000 through 2010 inclusive. Thirty-seven articles fulfilled the selection criteria. The results of this review highlight an association between perceived stress and postpartum depressive symptoms. However, because perceived stress has been evaluated in a general manner, it was not possible to identify events having more or less relation to postpartum depressive symptoms in mothers. Social support also appeared to be related to mothers' psychological health. Coping strategies were difficult to analyze because of the lack of homogeneity in their definition across studies. The comparison among studies of social support and coping strategies was also difficult due to the diversity of tools used and their lack of specificity. New tools should be specifically developed for the perinatal period, and further research should be performed to understand better the events and adequacy of social support.
Available from: Alfonso Gutierrez-Zotes
- "However, several authors (Besser and Priel 2003; Morling et al. 2003) found an inverse association between active coping and postpartum depressive symptoms. A recent review of PPD concluded that avoidance strategies are generally dysfunctional and linked to depressive symptoms (Razurel et al. 2013). Although a significant number of studies have analyzed the influence of coping strategies, these studies have not been conclusive. "
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ABSTRACT: The transition to motherhood is stressful as it requires several important changes in family dynamics, finances, and working life, along with physical and psychological adjustments. This study aimed at determining whether some forms of coping might predict postpartum depressive symptomatology. A total of 1626 pregnant women participated in a multi-centric longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the structured Diagnostic Interview for Genetic Studies (DIGS). The brief Coping Orientation for Problem Experiences (COPE) scale was used to measure coping strategies 2-3 days postpartum. Some coping strategies differentiate between women with and without postpartum depression. A logistic regression analysis was used to explore the relationships between the predictors of coping strategies and major depression (according to DSM-IV criteria). In this model, the predictor variables during the first 32 weeks were self-distraction (OR 1.18, 95 % CI 1.04-1.33), substance use (OR 0.58, 95 % CI 0.35-0.97), and self-blame (OR 1.18, 95 % CI 1.04-1.34). In healthy women with no psychiatric history, some passive coping strategies, both cognitive and behavioral, are predictors of depressive symptoms and postpartum depression and help differentiate between patients with and without depression.
Available from: Laura Orsolini
- "The postnatal period represents a relatively vulnerable phase for the mothers because of the physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset of psychiatric disorders (Gentile et al., 2007; Patil et al., 2011), especially in a context of lack of social support, isolation or unsatisfactory couple relationship (Razurel et al., 2013; Sidebottom et al., 2014), and a previous history of anxiety/mood disorders before and/or during the pregnancy (Howell et al., 2006; Dietz et al., 2007; Balestrieri et al., 2012). "
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The postnatal period represents a critical phase for mothers because of physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset/recrudescence of psychiatric disorders. Despite the evidence of an increasing utilization of antidepressant drugs during breastfeeding, there is still few reliable information on the neonatal safety of the selective serotonin reuptake inhibitors (SSRIs) and selective noradrenergic reuptake inhibitors (SNRIs) [serotonin reuptake inhibitors (SRIs)] in nursing mothers. The aim of this study is to provide a systematic review on the neonatal safety profile of these drugs during breastfeeding, also assessing the limits of available tools.
MEDLINE and PubMed databases were searched without any language restrictions by using the following set of keywords: ((SSRIs OR selective serotonin inhibitor reuptake OR SNRIs OR selective serotonin noradrenaline inhibitor reuptake) AND (breastfeeding OR lactation OR breast milk)). A separate search was also performed for each SSRIs (paroxetine, fluvoxamine, fluoxetine, sertraline, citalopram and escitalopram) and SNRIs (venlafaxine and duloxetine).
Sertraline and paroxetine show a better neonatal safety profile during breastfeeding as compared with other SRIs. Less data are available for fluvoxamine, escitalopram and duloxetine. Few studies followed up infants breastfeed for assessing the neurodevelopmental outcomes.
Literature review clearly indicates paroxetine and sertraline as the drugs that should be preferred as first line choice in nursing women who need an antidepressant treatment.
Available from: M. Antonia Biggs
- "Emotional social support has been found to be associated with reduced odds of negative emotional response after an abortion . Studies of women in the postpartum period have emphasized that emotional and instrumental social support are particularly important during this time [19,35,36]. Thus, emotional social support is important to consider when comparing receipt versus denial of abortion because low emotional support could contribute to development of health problems. "
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Examining women’s stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women’s well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups.
The Turnaway Study is a prospective cohort study of women who sought abortions at 30 abortion facilities across the United States, and follows women via semiannual phone interviews for five years. Participants include 956 English or Spanish speaking women aged 15 and over who sought abortions between 2008 and 2010 and whose gestation in pregnancy fit one of three groups: women who presented up to three weeks beyond a facility’s gestational age limit and were denied an abortion; women presenting within two weeks below the limit who received an abortion; and women who received a first trimester abortion. The outcomes were modified versions of the Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Longitudinal mixed effects models were used to assess differences in outcomes between study groups over 30 months.
Women denied abortions initially had higher perceived stress than women receiving abortions near gestational age limits (1.0 unit difference on 0-16 scale, P = 0.003). Women receiving first-trimester abortions initially had lower perceived stress than women receiving abortions near gestational age limits (0.6 difference, P = 0.045). By six months, all groups’ levels of perceived stress were similar, and levels remained similar through 30 months. Emotional social support scores did not differ among women receiving abortions near gestational limits versus women denied abortions or women having first trimester abortions initially or over time.
Soon after being denied abortions, women experienced higher perceived stress than women who received abortions. The study found no longer-term differences in perceived stress or emotional social support between women who received versus were denied abortions.
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