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Postpartum Anxiety Prevalence, Predictors and Effects on Child Development: A Review

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... Also consistent with Ayers et al. (2016), correlational analyses here showed that certain subjective factors, such as Anxious-Afraid, Postnatal Distress and EPDS scores, were directly related to more interventionist birth modes. erefore, these ndings provide further support for a pathway between obstetric interventions, lack of control, negative birth emotions and postpartum mood disturbances (Blom et al., 2010;Ayers et al., 2016;Field, 2017). In turn, negative postnatal maternal mood may adversely impact on mother-infant interactions and subsequent infant behaviour and development . ...
... ese mothers rated their midwife as helpful and informative and felt 'emotionally supported' throughout, re ecting evidence that Frontiers in Psychology | www.frontiersin.org 16 xx 2022 | Volume 13 | Article 792392 mothers experience less anxiety post-childbirth if they feel well cared for during the birth (Field, 2017). is pathway could occur physiologically via an easier birth and maternal recovery, with the mother's wellbeing during and post-birth encouraging neonatal wellbeing via their inter-connected hormonal systems (Buckley, 2015;Buckley and Uvnäs-Moberg, 2019). ...
... High-quality one-to-one midwifery care during childbirth may bene t the mother's physiological and psychological states (Olza et al., 2020) and consequently enhance her perceptions and experiences of her baby's behaviour. Conceivably, protecting the mother's neurohormonal state during childbirth and postnatally could also help to protect her against postpartum mood disorders and in this way promote more sensitive parenting and increase mother-infant bonding behaviours, with a positive impact on infant socio-emotional and cognitive development (Murray et al., 2014Field, 2017;Tichelman et al., 2019). is could bene t not only the mothers and infants themselves but also their families and the wider society in which they live. ...
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Objective To examine how physical and psychological childbirth experiences affect maternal perceptions and experiences of early infant behavioural style (temperament). Background Unnecessary interventions may disturb the normal progression of physiological childbirth and instinctive neonatal behaviours that facilitate mother–infant bonding and breastfeeding. While little is known about how a medicalised birth may influence developing infant temperament, high impact interventions which affect neonatal crying and cortisol levels could have longer term consequences for infant behaviour and functioning. Methods A retrospective Internet survey was designed to fully explore maternal experiences of childbirth and her postnatal perceptions of infant behaviour. Data collected from 999 mother–infant dyads were analysed using Pearson’s correlations and multiple analyses of covariance, employing the Bonferroni method of correction to establish initially significant variables. Multiple linear regressions were conducted to determine major perinatal contributors to perceived early infant temperament. Results Multiple regression analyses on each of the eight Mother and Baby Scales outcome variables indicated that early infant behavioural style (0–6 months) was largely predicted by subjective maternal states during and post-childbirth, postnatal depression scores, maternal personality traits and infant age. For example, infant age (Beta = 0.440, p = 0.000) was the most significant predictor of Alert-Responsive infant behaviour, followed by maternal Postnatal Positive experience (Beta = 0.181, p = 0.000). In contrast, depression (EPDS) scores (Beta = 0.370, p = 0.000) were the most significant predictor of Unsettled-Irregular infant behaviour, followed by Anxious-Afraid Birth Emotions (Beta = 0.171, p = 0.000) and infant age (Beta = −0.196, p = 0.000). Mothers also perceived their infants as more Alert-Responsive (Beta = 0.080, p = 0.010) and Easier overall (Beta = 0.085, p = 0.008) after a Supported birth experience. Conclusion Maternal and infant outcomes were influenced by multiple physical and psychological perinatal variables. The mother’s subjective experience appeared to be of equal significance to more objective factors (e.g. birthplace/mode). Social support enhanced the mother’s childbirth experience, benefitting her perceptions of her baby’s early temperament. These findings provide further support for current World Health Organisation intrapartum guidelines (2018) on the importance of making childbirth a ‘positive experience’ for women.
... Anxiety comprises panic attacks, social anxiety disorder, specific phobia, separation anxiety disorder, and generalized anxiety disorder. It is also divided into covert and obvious types in some anxiety tests [2,3]. An awful experience of childbirth following unexpected medical interventions, severe pain, and fear of death can cause severe anxiety [2]. ...
... An awful experience of childbirth following unexpected medical interventions, severe pain, and fear of death can cause severe anxiety [2]. Based on recent studies, the worldwide prevalence of postpartum anxiety has changed from 13 to 40% [3], while it has risen from 5 to 20% in Iran [2]. A study in Germany showed that 11.1% of women experience anxiety disorders within 3 months after delivery [4]. ...
... In fact, anxiety can be a cause of depression, which is a multifactorial disorder that originates from genetic and environmental factors [2]. Various risk factors in postpartum anxiety include demographic characteristics, pregnancy, and childbirth and breast-feeding, infertility, hormonal changes, inadequate social skills and lack of social support, a history of psychological problems and tensions, a negative perception of the birth experience, pain severity, and even fear of death [3]. For most women, pregnancy and childbirth are enjoyable events although many important physiological and psychological changes stemming from this period may lead to pathological and anxiety disorders, which can negatively affect bonding and mother-infant interactions [6]. ...
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Background: Pregnancy and delivery are considered as pleasant physiological phenomena. This period, however, sometimes leads to variable mood states in women and makes them more sensitive to psychological stimuli and problems. Objectives: The present study aimed to investigate the role of breastfeeding, type of delivery, contraceptive method, planned pregnancy, and history of infertility on the anxiety level of Iranian women who referred to health centers in Zanjan in the postpartum period. Methods: This cross-sectional study was conducted on 420 women who attended the health care centers in Zanjan city, Iran, during 2018-2019. A checklist including questions about demographic and reproductive information and Beck anxiety inventory were used as the data collection instruments. The data were analyzed using SPSS 21 software through regression analysis. Results: This study found that the history of infertility (β=0.26, t=9.38, p
... In addition to biological vulnerability, it is well-established that socioeconomic disadvantage confers important risk factors for maternal psychological distress. For example, young maternal age, low socioeconomic status, poor social support and/or marital relationship, history of abuse and/or domestic violence, and food insecurity are associated with depression and anxiety in mothers (Beydoun, Beydoun, Kaufman, Lo, & Zonderman, 2012;Biaggi, Conroy, Pawlby, & Pariante, 2016;Chung et al., 2004;Dolbier et al., 2013;Field, 2017;Leung, Epel, Willett, Rimm, & Laraia, 2014;Norhayati, Hazlina, Asrenee, & Emilin, 2015;Sockol et al., 2014;Wu, Chen, & Xu, 2012). Additional risk factors for elevated anxiety symptoms include being employed and having a high level of education (Field, 2017) highlighting the inconsistencies in the field between predictors across individual psychological distress symptoms. ...
... For example, young maternal age, low socioeconomic status, poor social support and/or marital relationship, history of abuse and/or domestic violence, and food insecurity are associated with depression and anxiety in mothers (Beydoun, Beydoun, Kaufman, Lo, & Zonderman, 2012;Biaggi, Conroy, Pawlby, & Pariante, 2016;Chung et al., 2004;Dolbier et al., 2013;Field, 2017;Leung, Epel, Willett, Rimm, & Laraia, 2014;Norhayati, Hazlina, Asrenee, & Emilin, 2015;Sockol et al., 2014;Wu, Chen, & Xu, 2012). Additional risk factors for elevated anxiety symptoms include being employed and having a high level of education (Field, 2017) highlighting the inconsistencies in the field between predictors across individual psychological distress symptoms. Risk factors associated with increased perinatal maternal stress include young age, low-income, low educational attainment, history of sexual abuse, stressful life events in the last month, smoking, alcohol consumption, low social support, preterm birth, and pregnancy with complications (Graignic-Philippe, Dayan, Chokron, Jacquet, & Tordjman, 2014;Roy-Matton, Moutquin, Brown, Carrier, & Bell, 2011). ...
... Our study also found that having low income (< 100% the FPL) was only associated with an increase in stress symptomology. Previous literature exploring low-income status suggested a strong link between income and stress, depressive, and anxiety symptoms (Chung et al., 2004;Field, 2017;Garfield et al., 2015;Graignic-Philippe et al., 2014;O'Campo et al., 2016). In our study we did not find low-income status to be a significant predictor for elevated depressive symptomology in the full model. ...
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Up to 25% of postpartum women experience psychological distress including stress, depressive, or anxiety symptoms during the postpartum period. The purpose of this study was to explore the extent to which social determinants of health and allostatic load score, a 10-item index of biologic measures of chronic stress, predict psychological distress in low-income pregnant women over the first postpartum year. We conducted a secondary data analysis of the Child Community Health Research Network dataset. The psychological distress outcome variables were perceived stress (n = 842), depression (n = 845), and anxiety (n = 846) symptoms, all measured categorically over the first year postpartum (T1:1 month, T2: 24-29 weeks, T3: 50-65 weeks). Our predictors were social determinants of health (e.g., demographics, maternal hardship, percent poverty level, interpersonal violence, food security) and allostatic load score. Generalized linear mixed models were used to determine which predictors were significantly associated with psychological distress symptoms across the first postpartum year. Interpersonal violence was a statistically significant risk factor for stress, depression, and anxiety symptoms over the first year postpartum. Other significant risk factors included low-income level, nativity, and perceived food security. Receiving food stamps was a significant protective factor for stress symptoms. The significance of risk factors for psychological distress, both modifiable and non-modifiable, can be used as potential targets for further research, screening, and intervention. Future work should explore why and in what conditions these risk factors vary over time.
... 6 In Indian population, the prevalence of antenatal anxiety and postpartum anxiety was found to be 55.7% 7 and 13 to 40%, respectively. 8 Postpartum blues are characterized by gloomy and mild depressive symptoms which are transitory and self-limited. 9 The symptoms include sadness, irritability, anxiety, crying, exhaustion, decreased sleep, decreased concentration, appetite changes, and labile mood. ...
... On analyzing the level of depression among the perinatal population, we found a mild score of depression (5-6) in 10 participants in their first trimester, 24 in their second trimester,53 in their third trimester, and 29 in their postpartum phase; a moderate score of depression (7)(8) On analyzing the association between anxiety with their demographic factors, we found that in participants who are in their gestational, postpartum age, abnormal sleep duration, there is 1.2-fold increase risk for the development of anxiety (p ¼ 0.006); in participants with comorbid medical history (p ¼ 0.001) and who lost their appetite (p ¼ 0.01), there is 1.6-fold increased risk for the development of anxiety; in participants with sleep disturbance, there is 1.8-fold increase risk for the development of anxiety (p ¼ 0.002), in participants with morning sickness affecting their daily function, there is a 2-fold increased risk for the development of anxiety (p < 0.001); in participants who lost interest in having food that they liked, there is 2.5-fold increase risk for the development of anxiety (p < 0.001). ...
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Introduction The perinatal period is a critical time in a woman's life. The impact of perinatal mental disorders includes new evidence of an increase in their prevalence among young pregnant women. Perinatal mental disorders are one of the most common and undertreated morbidities. Early detection of perinatal mental illness may be supported by evidence on risk factors. Our study aimed to identify the prevalence and risk factors of anxiety and depression and to determine the association between them. Materials and Methods A prospective observational questionnaire-based study was conducted in the obstetrics and gynecology department of a tertiary care hospital for a duration of 6 months. With random sampling, 741 participants were recruited for the study based on inclusion and exclusion criteria. The data were analyzed using SPSS version 28. Results The prevalence of perinatal anxiety and depression was found to be 48.5 and 32.2%, respectively. We discovered a substantial link between perinatal depression and anxiety, with an odds ratio of 3.9. The predictors are gestational age, postpartum age, comorbid conditions, morning sickness, sleep disturbance, sleep duration, loss of appetite, loss of interest in their favorite food, type of family, and presence of risk in their pregnancy. Conclusion Early screening and intervention may drastically and significantly reduce mental disorders existing in the pregnant population. So as health care professionals, we suggest that screening and counseling for depression and anxiety could be included as routine processes in antenatal care.
... [6][7] The fluctuations in steroid hormone levels play a crucial role in emotion processing, affecting reactivity within a network that includes the amygdala, insula, anterior cingulate cortex, and the prefrontal cortex. 8 The decrease in steroid and oxytocin hormones influences maternal emotional well-being, [9][10][11] contributing to factors associated with psychological breakdown. Adequate emotion processing during the postpartum period is essential for immediate maternal-infant bonding, encompassing attention, the recognition of infant emotions, motivation, preoccupation of thought, and parental empathy. ...
... 6,12 Other factors, such as age, social support, parity, internal conflicts, etc., are related to postpartum depression. 11 These factors contribute to a mother's susceptibility to psychological breakdown. 5 Postpartum encompasses various psychological breakdowns, including postpartum blues, baby blues, postpartum depression, and postpartum psychosis. ...
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This study aimed to assess the impact of utilizing the "Happy Maternal Card," a self-talk intervention, on breastfeeding self-efficacy during the postpartum period. The research involved 28 mothers three days postpartum in Health Canter Care in Purwodadi regency, Indonesia, from February to March 2020, using a quasi-experimental pre-post design with a control group. The intervention group received self-talk sessions twice daily for a month, while the control group received information through a maternal book twice a week. Breastfeeding ability and independent infant care were measured using the Breastfeeding Self-Efficacy Scale. Results indicated a significant decrease in anxiety (p-value=0.000) and a positive impact on breastfeeding self-efficacy in the intervention group (p-value=0.001). The positive suggestions of self-talk empowered mothers cognitively, enabling them to handle stress and believe in positive suggestions, ultimately influencing behavior. This self-talk method has the potential for postpartum care to enhance maternal efficacy in managing psychological aspects, contributing to the success of exclusive breastfeeding.
... There are many studies in the literature that examine the negative effects of PPD on the wellbeing of the mother and baby. [24][25][26] In a study conducted by Fonsace et al. with 441 postpartum women, they showed that women at high risk for PPD had more dysfunctional beliefs about motherhood than women at low risk for dysfunctional beliefs (bad experiences, perfectionism, ideal-perfect mother role). [27] Pregnancy and childbirth are important events in a woman's life cycle, and good identification of risk factors and taking preventive measures PPD during this time will help reduce the devastating effects of PPD. ...
... Moreover, in our study, it was observed that the scores of LATCH decreased as the risk of PPD increased, and we thought that this was due to the negative effects of PPD on mother-infant attachment and interaction. [26] Looking at the other results of our study, the rates of breastfeeding initiation in the first 30 minutes, maternal breastfeeding satisfaction, perception of milk sufficiency, pacifier use, and cesarean section rates were lower in the group that breastfed successfully. These results were consistent with the literature. ...
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Aim: In this study, we aimed to examine the effects of peripartum mother's cognitive functioning, anxiety, and postpartum depression of mothers on the practice of exclusive breastfeeding. Material and Method: The pregnant women in the last trimester who were attended in the outpatient department of obstetrics and gynecology were included in the study as the study group. A total of three follow-ups were conducted in the study group. In our study Mini-Mental State Examination (MMSE) was used to assess cognitive functioning, State-Trait Anxiety Inventory (STAI) 1,2 to assess anxiety, Edinburgh Postnatal Depression Scale (EPDS) to assess postpartum depression, Breastfeeding Self-Efficacy Scale (BSES) to assess mother's self- efficacy in breastfeeding, LATCH Breastfeeding Assessment Tool to assess mother's and baby's breastfeeding technique. Results: All of 158 pregnant and 96 non-pregnant women were enrolled in the study. After delivery, there was a significant decrease in STAI 2 scores compared to the prenatal period (p=0.001) and a significant increase in MMSE scores (p=0.001). There was no difference in STAI 1,2 , and MMSE scores between the groups with and without successful breastfeeding (p >0.05). LATCH scores were statistically significantly higher in the group that successfully breastfed (p =0.001). LATCH (r=-0.427, p
... Postpartum depression and anxiety have many negative consequences on maternal and infant health that are not restricted to infancy, but can also extend into toddlerhood, school age, and even adulthood [8]. Maternal consequences include physical health, psychological health, relationship, and risky behaviors; the infant consequences include anthropometry, physical health, sleep, and motor, cognitive, language, emotional, social, and behavioral development as a conduct disorder in adolescents; and mother-child interactions, include bonding, breastfeeding, and the maternal role [9,10]. Research supports the idea that a combination of medicine, counseling, support groups, and self-help strategies are the most effective ways to treat depression and anxiety [11]. ...
... e Arabic DASS has been proven to discriminate between depression, anxiety, and stress. DASS-42 is a 42-item questionnaire designed to measure the negative emotional states of depression, anxiety, and stress, with 14 items for each scale, the authors used the questions related to depression (Qs: 3,5,10,13,16,17,21,24,26,31,34,37,38, and 42) and anxiety (Qs: 2, 4, 7, 9, 15, 19, 20, 23, 25, 28, 30, 36, 40, and 41). Respondents were asked to use 4-point severity/frequency scales to rate the extent to which they have experienced each state over the past 2 weeks as follows: 0 � did not apply to me at all, 1 � applied to me some of the time, 2 � applied to me to a good part of time, and 3 � applied to me most of the time. ...
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Postpartum depression (PPD) is a mood disorder that begins after childbirth and usually lasts beyond six weeks; depression is often comorbid with anxiety. The main objectives of this work were to measure the prevalence of postpartum depression and/or anxiety among females in the Qaliubeya governorate to explore the underlying factors of these disorders and find if progesterone level has a role. A crosssectional study was conducted upon 500 postpartum females attending primary health care facilities in the Qaliubeya governorate. Data were collected by an interview questionnaire which included data about sociodemographic, obstetric, and past history and the Arabic version of DASS for assessment of postpartum depression and/or anxiety. The results showed 1.6% of the studied females suffered postpartum depression alone, 10% suffered from anxiety alone, and 21.2% suffered from both. The mean age of female who suffered from comorbid depression and anxiety was significantly ( p=0.01 ) higher than the normal group (26.9 and 25.1, respectively), and they had a significantly lower socioeconomic score than the normal ones (31.1 and 34.1, respectively), p<0.05 . There was a significant association ( p<0.001 ) between the past history of similar conditions and the current prevalence of postpartum disorders. ROC curve analysis showed that the progesterone level ≤4.6, ≤11.3, and ≤2.8 significantly predict depression alone, anxiety alone, and comorbid diseases, respectively. It was concluded that postpartum depression and/or anxiety affect 32.8% of females in the Qaliubeya governorate. Very low socioeconomic level, lower educational levels, past history of similar conditions, and low progesterone level are the significant predictors.
... Maternal mental health has, to a large degree, become synonymous with postpartum depression (PPD) in patient circles and in the public eye (Barkin, Willis, et al., 2017;Chris Sikes, personal communication, Houston County Nurse Manager, Georgia Department of Public Health, 2018). This has occurred despite a prevalence of postpartum anxiety (13% to 40%; Field, 2017) that rivals PPD's prevalence rates (10% to 20%; Centers for Disease Control and Prevention, 2018). It is also possible that postpartum anxiety is as (or more) prevalent as PPD but goes undetected as related screening is not nearly as common (Field, 2017). ...
... This has occurred despite a prevalence of postpartum anxiety (13% to 40%; Field, 2017) that rivals PPD's prevalence rates (10% to 20%; Centers for Disease Control and Prevention, 2018). It is also possible that postpartum anxiety is as (or more) prevalent as PPD but goes undetected as related screening is not nearly as common (Field, 2017). In addition to obsessive compulsive disorder and bipolar disorder, which can also occur in the perinatal period, posttraumatic stress disorder also has the potential to significantly affect quality of life and can be comorbid with depression and anxiety (Polachek, Harari, Baum, & Strous, 2012). ...
Article
BACKGROUND: Postpartum depression is the most common complication of childbearing can affect the entire family unit. Health professionals must strive to identify and develop effective, feasible solutions for women during this critical period. AIMS: To determine whether postpartum maternal functioning (as measured by the Barkin Index of Maternal Functioning) and depression symptoms (as measured by the Patient Health Questionnaire-9) were improved after participation in the Visiting Moms program. METHOD: Paired data were collected from women at program intake and after completion of the Visiting Moms program. Visiting Moms provides services through eastern and central Massachusetts and was designed to support new mothers throughout the infant’s first year of life. The study population was composed of adult women living in the Jewish Family and Children’s Services geographic catchment area, who enrolled in Visiting Moms between January 1, 2013, and December 31, 2015. Descriptive statistics were calculated for all 402 women enrolled in this timeframe. Utilizing a pretest/posttest design, paired t tests were performed for the Barkin Index of Maternal Functioning ( n = 149) and for the Patient Health Questionnaire-9 ( n = 156), where women had complete scores at both intake and completion, to determine the program’s potential impact on depressive symptoms and functional status. RESULTS: Functioning and depression scores were significantly improved after participation in the program. CONCLUSIONS: Visiting moms, and similar programs, aimed at delivery of enhanced social support, may be effective in promoting mental and emotional wellness among new mothers who are require additional support in the postpartum period.
... More women suffer from PMADs than from preeclampsia, postpartum hemorrhage, and gestational diabetes combined (DeSisto, Kim, & Sharma, 2014;Lisonkova & Joseph, 2013;Verreault et al., 2014). Research shows that most of these illnesses go untreated and that untreated PMADs can have long-term negative effects on the mother, infant, and entire family (Field, 2017;Granat, Gadassi, Gilboa-Schechtman, & Feldman, 2017;Murray, Fearon, & Cooper, 2015). Suicide is a leading cause of maternal death, accounting for approximately 20% of maternal deaths in the 1st year postpartum (CDC Foundation, 2018). ...
... Too many parents and providers believe that women suffering PMADS face an either/or decision: either treat their PMADs with psychotropic medication or continue breastfeeding (Esposito et al., 2017;Felitti, 2017;Field, 2017;Granat et al., 2017;Murray et al., 2015). Fortunately, this is not true for most postpartum mental health conditions. ...
... More women suffer from PMADs than from preeclampsia, postpartum hemorrhage, and gestational diabetes combined (DeSisto, Kim, & Sharma, 2014;Lisonkova & Joseph, 2013;Verreault et al., 2014). Research shows that most of these illnesses go untreated and that untreated PMADs can have long-term negative effects on the mother, infant, and entire family (Field, 2017;Granat, Gadassi, Gilboa-Schechtman, & Feldman, 2017;Murray, Fearon, & Cooper, 2015). Suicide is a leading cause of maternal death, accounting for approximately 20% of maternal deaths in the 1st year postpartum (CDC Foundation, 2018). ...
... Too many parents and providers believe that women suffering PMADS face an either/or decision: either treat their PMADs with psychotropic medication or continue breastfeeding (Esposito et al., 2017;Felitti, 2017;Field, 2017;Granat et al., 2017;Murray et al., 2015). Fortunately, this is not true for most postpartum mental health conditions. ...
... (Hahn-Holbrook, Cornwell-Hinrichs and Anaya, 2018). Sadness, excessive weeping, impatience, restlessness, sleep problems, anxiety, obsessive behavior, low mood, decreased interest/pleasure, and psychomotor agitation/retardation are the main symptoms of PPD (Field, 2017). The onset of these symptoms, which may be minor to severe, can happen at any point between the time of delivery and one year thereafter (Felder et al., 2017). ...
... In Indonesia, the percentage of exclusively breastfed infants aged 0-6 months was 80% in 2021, while in East Java province it was only 71.50%, lower than the national level. According to the literature, physical challenges, being a primiparous mother, fatigue, physiological changes, and concerns about baby care and breastfeeding were the potential factors for early cessation of breastfeeding [3][4][5][6][7][8]. ...
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Lactation relies on the secretion of two key hormones, prolactin and oxytocin. Studies have shown that yoga in the postpartum period can stimulate feelings of comfort and relaxation, which increases oxytocin production. The aim of this study was to evaluate the effect of yoga training on postpartum prolactin and oxytocin levels in a group of primipara women. This quasi-experimental study included 60 healthy primigravida, primipara women in their third trimester who attended antepartum and postpartum care at four primary healthcare centers in Kediri Regency. The participants were randomly allocated to an intervention group (n = 30) and a control (n = 30) group. The intervention group received health education and participated at eight yoga sessions with a duration of 60 min, from week 32 of gestation until the postpartum period. The control group received standard antepartum and postpartum care. Prolactin and oxytocin levels were measured in weeks 1 and 6 postpartum. Mean prolactin increment was significantly higher in the intervention group (176.8 ± 66.6 ng/ml) than the control group (24.8 ± 39.5 ng/ml). Similarly, mean oxytocin increment was significantly higher in the intervention group (58.6 ± 31.59 pg/ml) than the control group (14.6 ± 36.06 pg/ml). Our results suggest that yoga training in the third trimester until the postpartum period increases prolactin and oxytocin levels among primipara postpartum women.
... However, in a large subset of mothers, these phases also represent a risk period for the development of postpartum disorders such as postpartum depression (PPD), anxiety (PPA) and cognitive deficits (Zhang et al., 2021). PPD and PPA have many negative consequences on maternal health (Ali et al., 2013), which include biological and psychological factors, risky behaviours and motherchild interactions (Slomian et al., 2019;Field, 2017). Cognitive decline was also reported to have consequence on mother-child interactions (Postma et al., 2014;Albin-Brooks et al., 2017). ...
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This study examines the effect of gestational administration of aqueous leaf extract of Jatropha tanjorensis (JT) on postpartum-like behavioural outcomes to delineate its possibility as a prophylactic, therapeutic agent in the treatment of postpartum symptoms. Inseminated female rats (120-150g) were grouped into two-control and JT group (n=10). Control received 20 ml/kg of distilled water and JT group received 500 mg/kg of JT orally once daily for 21 days in gestation. Non-pregnant rats were excluded from the study. Parameters assessed at postpartum include antidepressant-like (force swim test, FST; tail suspension-test, TST), locomotor (open field test, OFT), anxiolytic-like (elevated plus maze, EPM; light-dark box, LDB), learning and memory (T-maze; novel object recognition task, NORT), social (nest score) and analgesic-like (hot plate test, HPT; tail flick test, TFT) behaviours. JT increased (P<0.05) mobility and latency to immobility durations in FST and TST; open arm entry (P<0.001) and duration (P<0.01) in EPM and light box duration (P<0.05) in LDB; locomotion and exploration, but reduced anxiety-like levels in EPM, LDB and OFT. It increased nest score (P<0.05); mean retraction time (P<0.01) of TFT. JT showed positive score for short and long term memory in NORT and improved percentage alternation in T-maze though not significant compared to control. In conclusion, the aqueous extract has a therapeutic effect that reduces postpartum-like depression and anxiety, and improves locomotor activity. JT can be a preventive and adjuvant therapeutic option for pregnant women
... The repercussions can also be seen on physical and psychological health of mothers, occupational functioning and risky behaviors [3]. For infants the extensive consequences of PPD are not limited to only early developmental stages but continue to influence development in adolescence and adulthood including atypical neurodevelopment [4] anthropometry, language, physical health, motor, emotional and social functioning [5]. ...
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Background and objective Motherhood is considered to be a joyous occasion cross-culturally but can bring forth an array of issues including depression. In Asia, Pakistan is dangerously high on the prevalence of postpartum depression (PPD) with sporadic results ranging from 28 to 63%, which could be due to the use of non-indigenous tools. Methods An exploratory study-mixed method design was implied. During phase I mothers in the postpartum phase (up to 12 months) and experts were interviewed, items were generated, and pilot study was conducted. In second phase exploratory and confirmatory factor analysis was conducted to establish construct validity, convergent and divergent validity was also established. Results A pool of 46 items was generated related to postpartum depression, which was reduced to 35 items as per the factor loading of 0.5 in exploratory factor analysis. Psychometric properties of the scale revealed good reliability (Cronbach α = 0.92) and factor structure of the scale. As per exploratory factor analysis five factors were revealed, explaining 58.07% variance, and the model was confirmed by confirmatory factor analysis. The scale showed significant positive correlation with Edinburgh' postpartum depression scale, depression anxiety and stress scale; establishing convergent validity and significant negative correlation with satisfaction with life scale; establishing divergent validity of the scale. Conclusion and implications for translation Questionnaire of postpartum depression scale is a reliable and valid tool that can be used to measure postpartum depression in Asian mothers and provide targeted interventions.
... While the association between mothers' and especially partners' subjective birth experience and symptoms of depression and anxiety after the first year postpartum is therefore not clear yet, it is clear that parents' mental health is associated with each other: a recent meta-analysis found that maternal postpartum depression predicts later paternal postpartum depression and the other way around (Thiel et al., 2020), highlighting the need for studies investigating how family members influence each other. More knowledge is needed not only to ensure parents' mental health but also a healthy development of their children, which is reliant on parents' well-being (Bradley and Slade, 2011;Brennan et al., 2000;Field, 2017;Junge et al., 2017). Therefore, this study will analyze the dyadic, longitudinal associations between parents' birth experience and their symptoms of depression and anxiety after birth. ...
... According to research by (Paul et al., 2013), mothers who gave birth vaginally were considerably less likely to screen positively for Post-Partum Anxiety than those who underwent cesarean sections (C-sections). Studies by (Field, 2017;Vickers, 2017) also corroborate this finding. Bhattarai et al. (2021)pointed out that one of the most important life experiences of a woman is her labor and delivery. ...
... It was determined that approximately 40% of the mothers participating in our research had mild or high levels of anxiety. A review article by Field et al. (2017) reported that the incidence of postpartum anxiety was between 13-40%, supporting our findings. Maternal anxiety in the postpartum period is a well-known phenomenon, and has received particular interest from researchers (Akbayrak 2014; Britton, 2005;Erdem et al., 2010;Kaplan et al., 2007;Matthies et al., 2019;Yildiz &, Dennis et al., 2017). ...
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Aim: The present study aimed to determine whether there was a relationship between anxiety and discharge readiness during early postpartum period in women who had given birth via vaginal delivery. Method: The sample of study consisted of 93 mothers hospitalized in our postpartum ward after vaginal delivery. Research data were collected using “Personal Information Form”, “State scale of the State-Trait Anxiety Inventory(STAI)” and “Readiness for Hospital Discharge Scale–New Mother Form(RHD-NMF)”. Descriptive statistics, Student's t-test, one-way analysis of variance (ANOVA), Tukey’s test and Pearson’s correlation coefficients were used in evaluation of the data. Results: The mean age of the mothers included in the study was 25.37±5.40 years. The mean STAI and RHD-NMF scores of the mothers were 35.15±9.59 and 145.64±32.35, respectively. It was determined that 11.8% of mothers were not ready for discharge and 39.8% had anxiety. A statistically significant moderate negative correlation was found between STAI and RHD-NMF scores (r=-0,445; p
... Furthermore, an unsettled infant could lead to further maternal distress [100]. Negative postpartum mood may also affect mother-infant interactions, resulting in more insecure attachments [101][102][103][104]. Subsequently, insecure attachments can affect infant emotional self-regulation and behaviour [28]. ...
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Background Childbirth has become increasingly medicalised, which may impact on the mother’s birth experience and her newborn infant’s physiology and behaviour. Although associations have been found between a mother’s subjective birth experience and her baby’s temperament, there is limited qualitative evidence around how and why this may occur. Objectives This qualitative study aimed to explore mothers’ childbirth and postnatal experiences, perceptions of their baby’s early behavioural style, and whether they saw these as related. Methods A qualitative semi-structured interview schedule collected rich in-depth data. Twenty-two healthy mothers over 18 years of age and with healthy infants aged 0–12 months born at term, were recruited from Southwest regions of England and Wales. Thematic analysis was performed on the data. Results Mothers experienced childbirth as a momentous physical and psychological process. However, they did not necessarily perceive the birth as affecting their baby’s early behaviour or temperament. While some mothers drew a direct relationship, such as linking a straightforward birth to a calm infant, others did not make an explicit connection, especially those who experienced a challenging birth and postnatal period. Nevertheless, mothers who had a difficult or medicalised birth sometimes reported unsettled infant behaviour. It is possible that mothers who feel anxious or depressed after a challenging birth, or those without a good support network, may simply perceive their infant as more unsettled. Equally, mothers who have been well-supported and experienced an easier birth could be more likely to perceive their baby as easier to care for. Conclusions Childbirth is a physical and psychological event that may affect mother-infant wellbeing and influence maternal perceptions of early infant temperament. The present findings add to prior evidence, reinforcing the importance of providing good physical and emotional support during and after childbirth to encourage positive mother-infant outcomes.
... Likewise, postpartum anxiety has been acknowledged as being commonplace and a potential cause of atypical attachment styles into childhood (Brockington, 2004). Prevalence rates of postpartum anxiety range from between 13% and 40% of all mothers (Field, 2017), yet it has received less empirical attention compared to postpartum depression (Bell et al., 2016). Studies suggest mothers of premature infants have significantly increased levels of anxiety compared to mothers of term infants, especially after extended NICU stays (Bonacquisti et al., 2020). ...
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Studies concerning the effect of a premature birth on maternal mental health suggest symptoms of depression and anxiety are more prevalent in mothers of premature infants compared to mothers of term infants. However, most studies investigating depressive symptoms only relate to a few months postpartum, whilst no anxiety measures used have been postpartum-specific. Additionally, symptoms of anxiety and depression in mothers of extremely premature infants (<28 weeks’ gestation) are relatively understudied. The aim of this study was to investigate the relationship between early gestational age and symptoms of anxiety and depression, with a secondary emphasis on mothers of extremely premature infants. 225 mothers of infants aged between birth and 12 months completed the Edinburgh Postnatal Depression Scale and the Postpartum Specific Anxiety Scale via an online questionnaire. Hierarchical regression models revealed that gestational age was associated with postpartum specific anxieties and was differentially associated with subscales of the PSAS. Furthermore, mothers of extremely premature infants experience specific subscales in the PSAS to a higher extent than mothers of term infants. There was no association between prematurity and depressive symptoms. These findings demonstrate the need for specific, targeted interventions for mothers of premature infants.
... In such conditions, mothers are more likely to face decreased self-esteem and increased depression during their postpartum period (Kamysheva et al., 2008). The prevalence of postpartum anxiety and depression is thought to be approximately 10-20 % and 15-40 %, respectively (Claesson et al., 2010;Falah-Hassani et al., 2016;Field, 2017;Nakić Radoš et al., 2018;Payne and Maguire, 2019;Stuart et al., 1998;Wenzel et al., 2003). Suffering from postpartum depression can have detrimental health outcomes for both mother and child (Brummelte and Galea, 2016;Slomian et al., 2019). ...
Article
Pregnancy is a very complex and highly stressful time in which women become more physically and emotionally vulnerable. Therefore, mothers are more likely to face decreased self-esteem and increased postpartum depression. Despite the high prevalence of postpartum depression, more than 50% of mothers are undiagnosed or untreated, showing an urgent need to explore an effective preventive strategy. A healthy lifestyle and regular physical activity have been suggested to be associated with an increased quality of life in pregnant and postpartum women. The purpose of this study was to determine whether swimming exercise before and during pregnancy can affect maternal care and postpartum depression-related behaviors in dams. To this end, female NMRI and C57BL/6 J mice were subjected to swimming exercise before conception and throughout pregnancy. On postpartum days 1-2, maternal behavior including nest building, active nursing, and licking/grooming were monitored. A battery of behavioral tests was also used to measure depression-related symptoms including anhedonia- and anxiety-like behavior, social behavior, and behavioral despair. To identify the underlying mechanisms, corticosterone and inflammatory cytokines during late pregnancy, and corticosterone and brain serotonin during the postpartum period were measured in dams. The findings indicated that swimming exercise increased gestational corticosterone, decreased maternal care and brain serotonin, and increased all depression-related behaviors in postpartum C57BL/6 J dams, while only increased licking/grooming and social behavior, and reduced anhedonia-like behavior in postpartum NMRI dams. Taken together, this study suggests that swimming exercise before and during pregnancy could alter maternal care and postpartum depression-like behavior in a strain-dependent manner.
... Postpartum anxiety is common, with 15 % of postnatal women reporting significant anxiety symptoms (Dennis et al., 2017). Anxiety in the postpartum period has been associated with excessive worry, panic attacks, trouble breathing, difficulties in parenting and bonding, reduced breastfeeding, and difficult temperament in infants (Field, 2017;Wardrop and Popadiuk, 2013). Risk factors for postpartum anxiety include lower socio-economic status (Leach et al., 2017), primiparity (Martínez-Galiano et al., 2019), past history of mental health issues, and "adverse circumstances around the pregnancy and birth" (Leach et al., 2017, p. 1). ...
Article
Background: While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety. Methods: Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used. Results: Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety. Limitations: Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status. Conclusions: These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.
... This result is congruent with Dennis (1999) applying Bandura's self-efficacy theory to breastfeeding, considering that self-efficacy is influenced by physiological responses (eg anxiety). This result is also consistent with those of previous studies reporting that women with high anxiety are at higher risk for early cessation of exclusive breastfeeding and shorter breastfeeding duration (Field, 2017;Fallon et al., 2016). ...
Article
The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was developed to measure a mother's confidence in her ability to breastfeed her infant. The definition of cutoff points for this scale would be a relevant tool to screen mothers in need of specific interventions to prevent early exclusive breastfeeding cessation. Aims: To examine (1) the psychometric characteristics of the Portuguese version of the BSES-SF and (2) the accuracy of the scale scores to predict exclusive breastfeeding cessation at 1, 3 and 6 months, and to select cutoff scores. Methods: The sample had 181 mothers. Exclusive breastfeeding was assessed at 1, 3 and 6 months postpartum. To examine the scale's psychometric characteristics, internal validity and criterion validity analyses were performed. The scale's predictive validity was studied according to infant feeding method. Receiver Operating Characteristic curves were used to assess the scale's predictive accuracy and to select the corresponding cutoff point. Key findings: The scale significantly predicted exclusive breastfeeding at 1, 3, and 6 months postpartum. Optimal clinical cutoff scores of 54, 55, and 57 were proposed respectively at 1, 3 and 6 months postpartum. Conclusion: The BSES-SF is a reliable instrument to assess a mother's breastfeeding self-efficacy and to screen mothers at risk of early exclusive breastfeeding cessation.
... Research has demonstrated that common mental disorders have steadily increased in women over the years, with onset of depression and anxiety being more likely to occur at childbearing age than any other time of life [1]. Postnatal depression (PND) has received more research attention in the field of perinatal mental health; however, more recent evidence suggests postpartum anxiety (PPA) exists as a distinct condition and may occur at a higher rate than PND [2,3]. Existing studies have demonstrated associations between PPA and various negative maternal and infant health outcomes, including impaired maternalinfant bonding [4], perceptions of difficult infant temperament [5], reduced maternal self-efficacy [6], and poor infant feeding outcomes [7]. ...
Article
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(1) Background: Existing literature has identified associations between exclusive breastfeeding, maternal mental health, and infant sleep. This study aims to examine these relationships simultaneously and consider the mediating role of postpartum anxiety. (2) Methods: Participants completed validated measures of postpartum anxiety, infant sleep, and reported exclusive breastfeeding duration. Postpartum mothers with infants between six and twelve months (n = 470) were recruited to a cross-sectional online survey containing a battery of psychological measures. (3) Results: Correlation analyses examined the relationships between the predictor (exclusive breastfeeding duration), outcome (perceptions of infant sleep), and mediator (postpartum anxiety). Exclusive breastfeeding duration was significantly associated with postpartum anxiety (p < 0.05), postpartum anxiety was significantly associated with perceptions of infant sleep (p < 0.001), and exclusive breastfeeding duration was significantly associated with perceptions of infant sleep (p < 0.001). A simple mediation model was conducted, showing a significant total (B = −0.029 (0.010), p < 0.05), direct (B = −0.035 (0.009), p < 0.001), and indirect effect (B = 0.007, SE = 0.003, 95% CI = 0.000 to 0.014) of exclusive breastfeeding duration on perceptions of infant sleep via postpartum anxiety. (4) Conclusions: Associations were identified between exclusive breastfeeding duration, postpartum anxiety, and perceptions of infant sleep. The mediation model suggests postpartum anxiety may be an underlying mechanism which reduces exclusive breastfeeding duration and negatively affects maternal perceptions of infant sleep quality.
... Although empirical evidence demonstrates that postpartum depression, anxiety, and (childbirth-related) PTSD are treatable (77-82), many women still do not receive any or only non-guideline based treatment. For instance, postpartum anxiety can be concealed by postpartum depression and therefore overlooked (83), also because women affected by postpartum anxiety seek professional help less often than women with postpartum depression (84). In the case of childbirth-related PTSD, women are also often misdiagnosed with postpartum depression (61,85) and guideline-based treatment for childbirth-related PTSD is not offered to them as a result. ...
Article
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The cross-sectional study INVITE (INtimate partner VIolence care and Treatment prEferences in postpartum women) aims to examine treatment and counseling preferences and barriers in relation to the experience of intimate partner violence (IPV), depression and anxiety, and (childbirth-related) posttraumatic stress disorder (PTSD) among postpartum women in Dresden, Germany. Currently, the INVITE study consists of an interim sample of N = 1,787 participants with n = 891 completed interviews. Recruitment is ongoing, targeting a community sample of at least N = 4,000 women who complete various quantitative questionnaires via telephone interviews at 3–4 months postpartum. The differences in rates of IPV, postpartum depression and anxiety, and/or (childbirth-related) PTSD as well as treatment and counseling preferences and barriers between affected and non-affected women will be assessed. Further, predisposing variables, past and present stress exposure, enabling resources, as well as past and present health will be examined as predictors of service preferences and barriers. In this study protocol, the theoretical background, methods, as well as preliminary results regarding sociodemographic characteristics and birth-related factors of the interim sample are presented and discussed in terms of their socio-political relevance. Simultaneously assessing IPV, postpartum depression and anxiety, and (childbirth-related) PTSD will facilitate exploring comorbidities and concomitant special needs of affected women. Results of the INVITE study will therefore set the ground for well-aimed development and improvement of treatment and counseling services for the respective target groups by informing health care professionals and policy makers about specific preferences and barriers to treatment. This will yield the possibility to tailor services to the needs of postpartum women.
... Amennyiben figyelembe vesszük a szubklinikai szorongásos tüneteket, akkor ez az arány a korai postpartum időszakban 17-22%, a késői postpartum időszakban 15-33% is lehet [5,6]. Megjelenésüket számos tényező befolyásolja, például a terhesség időszakában jelentkező esetleges megterhelő, stresszes életesemények [6], a szociális támogatás alacsony szintje [7], korábbi művi terhességmegszakítás vagy a nem kívánt terhesség [8], a szülés módja (természetes vagy császár) és a pozitív pszichiátriai anamnézis [9,10]. ...
Article
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Összefoglaló. A szülés utáni időszakban megjelenő aggodalmak természetesnek tekinthetők, az anyák jelentős részénél azonban klinikai szintű szorongásos megbetegedés alakulhat ki. A postpartum időszakban a szorongásos tünetek gyakori előfordulása ronthatja az anya életminőségét, pszichés állapotát, s ezáltal kedvezőtlen hatást gyakorol az anya-gyermek kapcsolatra, a gyermek mentális fejlődésére, a párkapcsolatra, valamint a családi rendszer egyensúlyára. Kutatási eredmények igazolják, hogy a szorongásos zavar a későbbiekben megjelenő anyai depresszió előrejelzője lehet. A nemzetközi irányelvek (NICE) a peri- és postnatalis időszakban jelentkező szorongásos zavarok kezdeti kezelésében az alacsony intenzitású pszichoterápiás módszereket javasolják. Tanulmányunk elsődleges célja, hogy egy esetismertetésen keresztül, kérdőívekkel követve az állapot változását, bemutassuk a szülészet-nőgyógyászat területén alkalmazható, kis intenzitású pszichológiai intervenciók eszköztárát. Az utóbbi a kognitív viselkedésterápia alapmódszereit használja kórházi osztályos, illetve ambuláns keretek között. A pszichoedukációt, normalizálást és átkeretezést, problémafókuszú keresztmetszeti konceptualizálást, szisztematikus deszenzitizálást és problémamegoldó technikákat tartalmazó intervenciók hatására az anya jelentős szenvedést okozó szorongásos panaszai már négy pszichoterápiás találkozást követően csökkentek, az anya képessé vált arra, hogy gyermekét ellássa. A terápia hatékonyságát, a szorongás és a depresszió csökkenését a páciens szubjektív megélésén túlmenően az állapotkövető kérdőívek eredményei is teljesen mértékben alátámasztották. Eredményeink megerősítik, hogy az alacsony intenzitású pszichológiai intervenciók hatékonyan alkalmazhatók a kórházi osztályokon a szorongásos, depressziós panaszok csökkentésében és ezáltal költségkímélő módon a pszichés zavarok megelőzésében. Orv Hetil. 2021; 162(44): 1776-1782. Summary. The occurrence of postpartum worries is considered a normative phenomenon, although the threshold of anxiety reaches clinical level and can lead to the development of postpartum anxiety disorder for a significant number of new mothers. Frequent occurrence of anxiety-related symptoms can negatively influence the mother's quality of life, psychological status, the mother-child relationship, the newborn's mental development, the relationship of the couple as well as the balance of the family system as a whole. Studies show that postpartum anxiety disorder can lead to depression later on. International guidelines (NICE) suggest peri- and postnatal anxiety disorders to be treated using low intensity psychological interventions (LIPIs). The aim of this study is to present the different methods of LIPIs used in obstetrics and gynecology through a clinical case study, while monitoring the outcomes in the mothers' psychological status by the use of questionnaires. LIPIs contain the basics of cognitive behavioural therapy used in hospitals in both in- and outpatient care. After only four psychotherapy sessions using psychoeducation, normalizing and reframing, problem-centered cross-sectional conceptualisation, systematic desensitization and problem solving techniques, the mother's severe symptoms of anxiety decreased significantly, enabling her to take proper care of the newborn. The efficacy of the therapy was confirmed thoroughly not only by the subjective experience of the patient, but the results of the questionnaires used to follow the psychological status of the patient. Our results show that LIPIs can be effectively used as a cost-effective method to reduce symptoms of anxiety or depression, and to prevent the development of mental health problems among hospital patients. Orv Hetil. 2021; 162(44): 1776-1782.
... We investigate whether typically developing infants' neural responses to emotional faces are associated with maternal anxiety assessed postnatally. Maternal anxiety is common in the perinatal period (prevalence rates from 15% to 40%; Dennis, Falah-Hassani, & Shiri, 2017;Field, 2017). The neural circuitry supporting face and emotion processing develops during infants' first year (Conte et al., 2020;Xie et al., 2019). ...
Article
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Background Postnatal maternal anxiety is common (estimates as high as 40% prevalence) and is associated with altered mother–infant interactions (e.g., reduced maternal emotional expression and engagement). Neural circuitry supporting infants’ face and emotion processing develops in their first year. Thus, early exposure to maternal anxiety may impact infants’ developing understanding of emotional displays. We examine whether maternal anxiety is associated with individual differences in typically developing infants’ neural responses to emotional faces. Methods One hundred and forty two mother–infant dyads were assessed when infants were 5, 7, or 12 months old. Infants’ electroencephalographic (EEG) data were recorded while passively viewing female happy, fearful, and angry faces. Three event‐related potential (ERP) components, each linked to face and emotion processing, were evaluated: NC, N290, and P400. Infant ERP amplitude was related to concurrent maternal‐report anxiety assessed with the Spielberger State‐Trait Anxiety Inventory (Trait form). Results Greater maternal anxiety predicted more negative NC amplitude for happy and fearful faces in left and mid‐central scalp regions, beyond covarying influences of maternal depression symptoms, infant negative emotionality, and infant age. Conclusions Postnatal maternal anxiety is related to infants’ neural processing of emotional expressions. Infants of mothers endorsing high trait anxiety may need additional attentional resources to process happy and fearful faces (expressions less likely experienced in mother–infant interactions). Future research should investigate mechanisms underlying this association, given possibilities include experiential, genetic, and prenatal factors.
... These include associations with impaired maternal bond , reduced maternal self-efficacy (Matthies et al. 2017), adverse infant feeding outcomes (Fallon et al. 2018), difficult infant temperament (Britton 2011), and poor infant developmental outcomes (Glasheen et al. 2010). PPA also poses an economic burden to the health care system and wider society (Bauer et al. 2014), with prevalence rates ranging from 13 to 40% in high income contexts (Field 2017). It is therefore crucial that symptoms of anxiety are correctly identified and appropriately measured. ...
Article
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The Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure of postpartum anxiety (PPA). However, it contains 51 items, so is limited by its length. This study aimed to reduce the number of items in the PSAS, produce a small number of high-performing short-form tools, and confirm the factor structure of the most statistically and theoretically meaningful model. A pooled sample of English-speaking mothers (N = 2033) with infants up to 12 months were randomly split into three samples. (1) A principal component analysis (PCA) was conducted to initially reduce the items (n = 672). (2) Four short-form versions of varying length (informed by statistical, theoretical, lay-person, and expert-guided feedback) were developed and their factor structure examined (n = 673). (3) A final confirmatory factor analysis (CFA) was performed to confirm the factor structure of the PSAS Research Short-Form (PSAS-RSF) (n = 688). PCA and theoretical review reduced the items from 51 to 34 (version 1). Statistical review retained 22 items (version 2). Quantitative expert panel data retained 17 items (version 3). Qualitative expert panel data retained 16 items (version 4). The 16-item version was deemed the most theoretically and psychometrically robust. The resulting 16-item PSAS-RSF demonstrated good psychometric properties and reliability. The PSAS-RSF is the first brief research tool which has been validated to measure PPA. Our findings demonstrate it is theoretically meaningful, statistically robust, reliable, and valid. This study extends the use of the measure up to 12 months postpartum, offering broader opportunity for measurement while further enhancing accessibility through brevity.
... Anxiety during pregnancy is associated with adverse outcomes, including spontaneous abortion, preeclampsia, preterm delivery and low birth weight (Zhong et al., 2015). It is also linked to poor adherence to medical advice, poor nutrition, loss of resources and substance abuse (Dunkel, & Tunner, 2012) as well as to insecure attachment (Field, 2017); it is also a predictor of perinatal depression (Robertson, Grace, Wallington, & Stewart, 2004). The literature indicates that it also has a high healthcare cost because it is associated with a high level of utilization of health services (Sutter, Giaconne, Glatigny, & Verdoux, 2004). ...
... As postpartum anxiety is estimated to be highest between 6 and 8 weeks postpartum (Dennis et al., 2013;Field et al., 2017;Matthey et al., 2003;Wenzel et al., 2005), as well as having an impact on offspring development during this time (Ali et al., 2013;Barker et al., 2011), our primary outcome (anxiety worsening in the postpartum period), was defined using scores on the Hamilton Anxiety Rating Scale (HAM-A; Hamilton, 1959) at 6 weeks postpartum. We utilized the most commonly reported definition for anxiety worsening/ symptom relapse with the HAM-A, which is an increase of ≥50% from baseline scores (O'Sullivan et al., 1996;Pecknold et al., 1993;Roy-Byrne et al., 1989). ...
Article
Background: As many as 20% of women will experience an anxiety disorder during the perinatal period. Women with pre-existing anxiety disorders are at increased risk of worsening during this time, yet little is known about its predictors. Study Aim: To investigate the psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders. Methods: Thirty-five (n = 35) pregnant women with pre-existing DSM-5 anxiety disorders were enrolled in this prospective study investigating the psychosocial (e.g., childhood trauma, intolerance of uncertainty, depression) and biological risk factors (e.g. C-reactive protein, interleukin-6, tumor necrosis factor-α) for anxiety worsening in the postpartum period. Anxiety worsening was defined as an increase of ≥50% or greater on Hamilton Anxiety Rating Scale scores from the third trimester of pregnancy (32.94 ± 3.35 weeks) to six weeks postpartum. Results: Intolerance of uncertainty, depressive symptom severity, and obsessive-compulsive disorder symptoms present in pregnancy were significant predictors of anxiety worsening in the postpartum. Limitations: Sample heterogeneity and limited sample size may affect study generalizability. Conclusions: To our knowledge, this is the first longitudinal study to investigate psychosocial and biological risk factors for anxiety worsening in the postpartum in women with pre-existing anxiety disorders. Continued research investigating these risk factors is needed to elucidate whether they differ from women experiencing new-onset anxiety disorders in the perinatal period, and those in non-puerperal groups. Identifying these risk factors can guide the development of screening measures for early and accurate symptom detection. This can lead to the implementation of appropriate interventions aimed at decreasing the risk of perinatal anxiety worsening.
... [24][25][26] Findings are worse for anxiety, with prenatal rates between 18 and 25% 27 and postnatal rates between 13 and 40%. 28 A systematic review found a positive association between child sexual abuse and depressive symptoms in pregnancy, but an inconsistent association with postnatal depression. 9 For example, 25% of women exposed to child sexual abuse became depressed during pregnancy v. less than 2% of women not exposed. ...
Article
Adverse childhood experiences (ACEs) of parents are associated with a variety of negative health outcomes in offspring. Little is known about the mechanisms by which ACEs are transmitted to the next generation. Given that maternal depression and anxiety are related to ACEs and negatively affect children’s behaviour, these exposures may be pathways between maternal ACEs and child psychopathology. Child sex may modify these associations. Our objectives were to determine: (1) the association between ACEs and children’s behaviour, (2) whether maternal symptoms of prenatal and postnatal depression and anxiety mediate the relationship between maternal ACEs and children’s behaviour, and (3) whether these relationships are moderated by child sex. Pearson correlations and latent path analyses were undertaken using data from 907 children and their mothers enrolled the Alberta Pregnancy Outcomes and Nutrition study. Overall, maternal ACEs were associated with symptoms of anxiety and depression during the perinatal period, and externalizing problems in children. Furthermore, we observed indirect associations between maternal ACEs and children’s internalizing and externalizing problems via maternal anxiety and depression. Sex differences were observed, with boys demonstrating greater vulnerability to the indirect effects of maternal ACEs via both anxiety and depression. Findings suggest that maternal mental health may be a mechanism by which maternal early life adversity is transmitted to children, especially boys. Further research is needed to determine if targeted interventions with women who have both high ACEs and mental health problems can prevent or ameliorate the effects of ACEs on children’s behavioural psychopathology.
... Anxiety during pregnancy is associated with adverse outcomes, including spontaneous abortion, preeclampsia, preterm delivery and low birth weight (Zhong et al., 2015). It is also linked to poor adherence to medical advice, poor nutrition, loss of resources and substance abuse (Dunkel, & Tunner, 2012) as well as to insecure attachment (Field, 2017); it is also a predictor of perinatal depression (Robertson, Grace, Wallington, & Stewart, 2004). The literature indicates that it also has a high healthcare cost because it is associated with a high level of utilization of health services (Sutter, Giaconne, Glatigny, & Verdoux, 2004). ...
Article
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Symptoms of anxiety are one of the most prevalent emotional responses in women during their reproductive phase and especially during pregnancy. Objective: Estimate the incidence and prevalence of anxiety throughout the three trimesters of pregnancy in addition to studying the possible risk factors associated with anxiety symptoms. Method: A sample of 385 pregnant women participated in a longitudinal study in which the GAD-7 questionnaire was used. Results: Anxiety prevalence was 19.5% in the first trimester. In the second trimester, it was 16.8%, with an incidence of 0.048%. In the third trimester, it was 17.2%, with an incidence of 0.068%. The following predictive factors of anxiety symptoms were identified: being a smoker, presence of previous illness and changes in social relationships. Conclusions: High incidence and prevalence of anxiety symptoms occur during pregnancy; consequently, applicable preventive policies should be developed.
... Postpartum depression (PPD) and postpartum anxiety (PPA) affect 13-19% [1,2] of women worldwide, respectively. The impact of these disorders can range from immediate effects of self-harm, inadequate caregiving practices, reduced breastfeeding, to long-term consequences, such as maternal chronic depression and child temperament, cognitive, and behavioral issues [2][3][4][5]. These disorders often go undiagnosed and untreated due to the lack of awareness of symptoms and the associated stigma [6], thus preventive measures need to be identified to mitigate their risks. ...
Article
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Diet in the first month postpartum, otherwise known as "the confinement diet" in Asia, has unique characteristics that are influenced by traditions, cultures, and beliefs. We aimed to characterize dietary patterns during confinement period in a multi-ethnic Asian cohort and examined their associations with postpartum depression (PPD) and anxiety (PPA). Dietary intakes of 490 women were ascertained in the first month postpartum using 3-day food diaries and dietary patterns were derived by factor analysis. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) at three months' postpartum; higher scores are indicative of more depressive and anxiety symptoms, respectively. Four dietary patterns were identified: Traditional-Chinese-Confinement diet, Traditional-Indian-Confinement diet, Eat-Out diet and Soup-Vegetables-Fruits diet. The Traditional-Indian-Confinement diet was associated with less PPD symptoms [β (95% CI) -0.62 (-1.16, -0.09) EPDS score per SD increase in diet score] and a non-significant trend with reduced probable PPD (EPDS scores ≥ 13) [OR (95% CI) 0.56 (0.31, 1.01)]. The Soup-Vegetables-Fruits diet was associated with less PPA symptoms [β (95% CI) -1.49 (-2.56, -0.42) STAI-state score]. No associations were observed for other dietary patterns. Independent of ethnicity, adherence to the Traditional-Indian-Confinement diet that is characterized by intake of herbs and legumes, and Soup-Vegetables-Fruits diet high in fruits, vegetables and fish during the postpartum period were associated with less PPD and PPA symptoms, respectively.
... We consider how these intrapersonal experiences may shed light on new mothers' work-family conflict (WFC) and subsequent intent to stay with their organization after childbirth. Such a focus is important, given that for women in the United States, a typical maternity leave is just 12 weeks, leaving most mothers little time to build confidence in their new role and to be at greater risk of developing postpartum anxiety (Field, 2017;Mercer, 2004). Findings from our multimethod study reveal that maternal confidence is highly salient for new mothers as they begin the process of navigating work and family demands. ...
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Background Some women struggle with mental health problems such as postpartum depression (PPD) or postpartum anxiety disorder (PAD) after giving birth. This can have a negative impact on the new mother, the infant, and the whole family. However, many women experiencing PPD and/or PAD go unrecognized and untreated. Since appropriate support is essential, efforts should be made to facilitate women’s help-seeking behavior. The purpose of this study was to improve the mental health of postpartum women by understanding their specific support preferences. To this end, the preferences for counseling and treatment services, as well as the service delivery mode among women with PPD, PAD, comorbid PPD and PAD, and women with neither PPD nor PAD were examined. Methods In the cross-sectional study INVITE, mothers (n = 2,031) were interviewed via telephone about three to four months after birth. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), PAD was assessed using the anxiety scale of the Symptom-Checklist-90-Revised (SCL-90-R), and preferences for services and delivery modes were assessed using self-generated questionnaires. Analyses of variance were performed to examine differences between the symptom groups. Results All women preferred the support of (family) midwives and family, friends, or colleagues and to talk to someone in person. Analyses of variance showed that, overall, women with PPD preferred all services less than women with neither PPD nor PAD. Furthermore, women with PPD preferred psychotherapeutic services (e.g., inpatient clinic and outpatient clinic/treatment) less, and women with comorbid PPD and PAD preferred professional and personal confidants (e.g., midwife and women in the same situation) less than all other women. Women did not differ in their preferences for service delivery mode. Conclusions This study provides unique insight into postpartum women’s preferences for various services and delivery modes. Results showed that women differ in their preferences for services depending on their symptoms. This should be considered when making referrals, and postpartum support should be better tailored to mothers' wishes and needs to improve help-seeking behavior and ultimately postpartum mental health.
Article
Postpartum anxiety is a significant component of postpartum maternal distress and is related to adverse outcomes for both the mother and the child. Although previous research reported higher anxiety symptoms in pregnant women during the Covid-19 pandemic, no studies evaluated the negative impact of pandemic-related perceived stress on postpartum anxiety symptomatology over time. This study aimed to examine the impact of prepartum pandemic-related stress on postpartum anxiety and to evaluate the role of subjective labor and delivery experiences on this relationship. A sample of 172 pregnant women completed an online questionnaire evaluating pandemic-related perceived stress and anxiety symptoms in the second or third trimester of pregnancy. In the postpartum, they completed a second questionnaire retrospectively evaluating their childbirth experience and assessing anxiety symptoms in the last two weeks. A mediation analysis was conducted. Prepartum pandemic-related perceived stress was significantly associated with postpartum anxiety symptoms. Moreover, childbirth experiences significantly and partially mediated this relationship. Findings highlighted the importance of evaluating perceived stress levels during pregnancy to prevent negative consequences on postpartum mental health. Clinicians need to foster better management of factors included in the childbirth experience that may potentially trigger or counteract anxiety risk.
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Introduction The COVID-19 pandemic has had a unique impact on the mental health and well-being of pregnant individuals and parents of young children. However, the impact of COVID-19-related stress during pregnancy on early child biopsychosocial development, remains unclear. The COVID-19 Wellbeing and Stress Study will: (1) investigate the impact of different forms of prenatal stress experienced during the pandemic (including objective hardship, perceived psychological distress and biological stress) on child stress biology, (2) examine the association between child stress biology and child developmental outcomes, (3) determine whether child stress biology acts as a mechanism linking prenatal stress to adverse child developmental outcomes and (4) assess whether gestational age at the onset of the COVID-19 pandemic or child sex, moderate these associations. Methods and analyses The COVID-19 Wellbeing and Stress Study is a prospective longitudinal study, consisting of six time points, spanning from pregnancy to 3 years postpartum. The study began in June 2020, consisting of 304 pregnant people from Ontario, Canada. This multimethod study is composed of questionnaires, biological samples, behavioural observations and developmental assessments Ethics and dissemination This study was approved by the Hamilton Integrated Research Ethics Board (#11034) and the Mount Saint Vincent University Research Ethics Board (#2020-187, #2021-075, #2022-008). Findings will be disseminated through peer-reviewed presentations and publications, community presentations, and electronic forums (social media, newsletters and website postings).
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Introduction: mothers of preterm infants are exposed to stress leading to post-traumatic stress disorder (PTSD). Preterm births have increased lately with World Health Organization (WHO) reporting an estimated prevalence of up to 5-18% and Kenya reporting a prevalence of 18.3%. The current study sought to determine the prevalence of PTSD and its associated predictors among mothers with preterm infants. Methods: this was a hospital-based cross-sectional study among 182 mothers with preterm babies admitted in neonatal care units (NCUs) of two referral hospitals. A simple random sampling technique was used to select participants and data was collected using a semi-structured pretested questionnaire and an Impact of events scale-revised (IES-R). Analysis was done using STATA 15 and a significance level set at P≤ 0.05 and 95% confidence interval. Results: the majority of the respondents 67 (36.8%) were aged between 18-22 years and only 34 (18.7%) were above 34 years. Most of the respondents had attained secondary and tertiary level education at 86 (47.3%) and 51 (28.0%) respectively. Prevalence of PTSD was 78.6% at a confidence interval of 95% CI: 0.72-0.84. Mothers who had a previous preterm birth were 0.09 less likely to develop PTSD {AOR=0.09, 95% CI: 0.01-0.80, p=0.023} while those who underwent cesarean section were 11.1 times more likely to develop PTSD {AOR=11.1, 95% CI:1.1-114.8, p=0.043}. Conclusion: the prevalence of PTSD was 78.6%. Although mothers of preterm infants experience stress, the associated predictors included; cesarean section birth, having had a preterm birth before and staying in fair housing conditions.
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Background: Perinatal mood disorders such as depression and anxiety are common, with subclinical symptomology manifesting as perinatal mood disturbances being even more prevalent. These could potentially affect breastfeeding practices and infant development. Pregnant and lactating women usually limit their exposure to medications, including those for psychological symptoms. Interestingly, the naturally occurring probiotic Bifidobacterium longum (BL) NCC3001 has been shown to reduce anxious behavior in preclinical models and feelings of low mood in nonpregnant human adults. During the COVID-19 pandemic, mental health issues increased, and conventionally conducted clinical trials were restricted by social distancing regulations. Objective: This study, Probiotics on Mothers' Mood and Stress (PROMOTE), aimed to use a decentralized clinical trial design to test whether BL NCC3001 can reduce symptoms of depression, anxiety, and stress over the perinatal period. Methods: This double-blind, placebo-controlled, randomized, and 3-parallel-arm study aimed to recruit 180 women to evaluate the efficacy of the probiotic taken either during pregnancy and post partum (from 28-32 weeks' gestation until 12 weeks after delivery; n=60, 33.3%) or post partum only (from birth until 12 weeks after delivery; n=60, 33.3%) in comparison with a placebo control group (n=60, 33.3%). Participants consumed the probiotic or matched placebo in a drink once daily. Mood outcomes were measured using the State-Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale questionnaires, captured electronically at baseline (28-32 weeks' gestation) and during e-study sessions over 5 further time points (36 weeks' gestation; 9 days post partum; and 4, 8, and 12 weeks post partum). Saliva and stool samples were collected longitudinally at home to provide mechanistic insights. Results: In total, 520 women registered their interest on our website, of whom 184 (35.4%) were eligible and randomized. Of these 184 participants, 5 (2.7%) withdrew after randomization, leaving 179 (97.3%) who completed the study. Recruitment occurred between November 7, 2020, and August 20, 2021. Advertising on social media brought in 46.9% (244/520) of the prospective participants, followed by parenting-specific websites (116/520, 22.3%). Nationwide recruitment was achieved. Data processing is ongoing, and there are no outcomes to report yet. Conclusions: Multiple converging factors contributed to speedy recruitment and retention of participants despite COVID-19-related restrictions. This decentralized trial design sets a precedent for similar studies, in addition to potentially providing novel evidence on the impact of BL NCC3001 on symptoms of perinatal mood disturbances. This study was ideal for remote conduct: because of the high digital literacy and public trust in digital security in Singapore, the intervention could be self-administered without regular clinical monitoring, and the eligibility criteria and outcomes were measured using electronic questionnaires and self-collected biological samples. This design was particularly suited for a group considered vulnerable-pregnant women-during the challenging times of COVID-19-related social restrictions. Trial registration: ClinicalTrials.gov NCT04685252; https://clinicaltrials.gov/ct2/show/NCT04685252. International registered report identifier (irrid): DERR1-10.2196/41751.
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Perinatal Mood and Anxiety Disorders (PMADs) is a serious condition impacting up to 21 percent of woman after the birth of a child (Byrnes, 2018). Jane, a 32-year-old female presented for treatment for anxiety, depression and mood disturbance (5th ed.; DSM-5; American Psychiatric Association, 2013) and in need of feeling more connected to her baby and her life. The use of creative techniques including mindfulness, distress tolerance activity, emotion regulation, and interpersonal skills (Linehan, 2015, 2016) were implemented. The use of these skills can be added to the repertoire of practice of a mental health counselor working with clients with PMADs.
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This chapter highlights several of the most significant factors that have an overarching influence on caregivers’ feeding choices and propensity toward responsive feeding. Overall, the aim of this chapter is to illustrate how caregivers’ feeding practices and choices may be shaped by factors such as their perceptions of their infants’ behavior and weight status, previous experiences with child-rearing, familial and social supports, cultural practices and beliefs, and social and economic determinants of health.
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A growing body of evidence suggests voluntary physical activity is associated with decreased stress-related disorders such as anxiety- and depression-like behaviours in both humans and rodents. The postpartum period is also a vulnerable transition time for the development of these neurobehavioural disorders in women. This study aimed to determine whether voluntary physical activity during pregnancy and postpartum periods can increase maternal care and decrease anxiety- and depression-related behaviours in postpartum dams. To this end, pregnant mice were exposed to running wheel during their gestational and postpartum periods, and then nest building, active nursing, and licking/grooming behaviours were recorded as maternal care. To assess depression and anxiety-related symptoms, several behavioural tests such as the novelty-suppressed feeding test, tail suspension test, sucrose preference test, social interaction test, forced swim test, open field, elevated plus maze, light-dark box, and elevated zero maze were used. To identify the most important mechanisms behind these behavioural alterations, we measured oxytocin, adrenocorticotropic hormone (ACTH) and corticosterone in the serum and serotonin in the brain of postpartum dams. Our findings showed that running wheel significantly increased maternal care, and decreased depression-like behaviour during the postpartum period through increasing serum oxytocin and brain serotonin levels, whereas it decreased anxiety-like behaviour via attenuating the hypothalamic-pituitary-adrenal (HPA) axis activity by measuring ACTH and corticosterone levels in postpartum dams. Overall, this study suggests that voluntary physical activity during pregnancy and the postpartum period might improve maternal care and decrease anxiety and depression-related behaviours in postpartum dams.
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Menyusui merupakan landasan utama kelangsungan hidup bayi dan anak kecil, gizi dan perkembangan serta kesehatan ibu. World Health Organization (WHO) merekomendasikan pemberian Air Susu Ibu (ASI) eksklusif selama 6 bulan pertama kehidupan, diikuti dengan pemberian ASI berkelanjutan dengan makanan pendamping yang sesuai hingga 2 tahun ke atas; kontak kulit-ke-kulit yang dini dan tidak terputus serta rawat gabung; perawatan menggunakan metode kanguru juga secara signifikan meningkatkan kelangsungan hidup neonatal dan mengurangi morbiditas dan direkomendasikan oleh WHO. Namun, kekhawatiran telah muncul tentang apakah ibu dengan Coronavirus Disease 2019 (COVID-19) dapat menularkan virus Severe Acute Respiratory Syndrome Coronavirus Disease-2 (SARS- CoV-2) ke bayi atau anak melalui air susu. Buku “Menyusui Pada Masa Pandemi COVID-19” ini disusun sebagai bentuk kepedulian penulis pada ibu menyusui di masa pandemi COVID-19 agar tetap memberikan ASI pada bayi dengan memberikan informasi terkait protokol kesehatan yang perlu dipenuhi dalam pemberian ASI di masa pandemi. Selain itu, buku ini ditulis sebagai wujud ketertarikan penulis dalam hal peningkatan keberhasilan menyusui sehingga target ASI eksklusif dapat tercapai. Buku ini juga membahas tentang bukti empiris yang menjadi dasar pentingnya ASI tetap diberikan walaupun ibu telah dinyatakan positif Covid-19 sehingga dapat digunakan oleh mahasiswa kesehatan maupun kebidanan sebagai tambahan referensi. Selain itu buku ini juga dapat digunakan oleh praktisi dalam pelayanan kebidanan sebagai bahan referensi dalam memberikan informasi kepada ibu nifas dan ibu menyusui yang bekerja di luar rumah terkait cara menyusui masa pandemi Covid-19.
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