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      The effect of stress and anxiety associated with maternal prenatal diagnosis on feto-maternal attachment

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      1 , , 2 , 3
      BMC Women's Health
      BioMed Central

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          Abstract

          Background

          A couple's decision to undergo an invasive test based on a screening test result is a process associated with anxiety. The aim of this study was to determine whether anxiety and prenatal attachment were affected by undergoing an invasive test compared to women in early pregnancy and after a reassuring anomaly scan.

          Methods

          200 women were recruited at booking, 14 women and 20 partners after an invasive test and 81 women following an anomaly scan. A questionnaire was completed using the Beck Anxiety Inventory and Maternal or Paternal Antenatal Attachment Scales.

          Results

          Women who have had an invasive test have higher levels of anxiety compared to women at booking (P < 0.01) and after an anomaly scan (P = 0.002). Anxiety declines from booking to the time of an anomaly scan (P = 0.025), whilst attachment increases (P < 0.001). There is a positive correlation between anxiety and attachment in women who have had an invasive test (r = 0.479). Partners of women undergoing an invasive test experience lower levels of anxiety (P < 0.05).

          Conclusions

          Women undergoing prenatal diagnostic procedures experience more psychological distress, which may be currently underestimated. Establishment of interdisciplinary treatment settings where access to psychological support is facilitated may be beneficial.

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          Most cited references41

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          The thrifty phenotype hypothesis.

          The thrifty phenotype hypothesis proposes that the epidemiological associations between poor fetal and infant growth and the subsequent development of type 2 diabetes and the metabolic syndrome result from the effects of poor nutrition in early life, which produces permanent changes in glucose-insulin metabolism. These changes include reduced capacity for insulin secretion and insulin resistance which, combined with effects of obesity, ageing and physical inactivity, are the most important factors in determining type 2 diabetes. Since the hypothesis was proposed, many studies world-wide have confirmed the initial epidemiological evidence, although the strength of the relationships has varied from one study to another. The relationship with insulin resistance is clear at all ages studied. Less clear is the relationship with insulin secretion. The relative contribution of genes and environment to these relationships remains a matter of debate. The contributions of maternal hyperglycaemia and the trajectory of postnatal growth need to be clarified.
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            The assessment of antenatal emotional attachment: development of a questionnaire instrument.

            The nature of the relationship which female and male expectant parents develop during pregnancy with their unborn baby has both theoretical and clinical significance. It potentially provides a framework for improved understanding of many aspects of psychosomatic obstetrics, including reactions to foetal loss. Existing instruments designed to assess this relationship inadequately differentiate between attitude to the foetus per se versus attitude to the pregnancy state or motherhood role. The present paper presents a theoretical model of the subjective experiences of human attachment. This is utilized to develop a questionnaire to assess the antenatal attachment construct. Item analysis results in a 19-item maternal and 16-item paternal questionnaire with high levels of internal consistency. Each takes approximately five minutes to complete. Finally, the factor structures of the resultant questionnaires are explored.
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              The State--Trait Anxiety Inventory, Trait version: structure and content re-examined

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                Author and article information

                Journal
                BMC Womens Health
                BMC Women's Health
                BioMed Central
                1472-6874
                2011
                12 July 2011
                : 11
                : 33
                Affiliations
                [1 ]Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, 4th Floor, Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK
                [2 ]Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, South Yorkshire, UK
                [3 ]Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, South Yorkshire, UK
                Article
                1472-6874-11-33
                10.1186/1472-6874-11-33
                3148201
                21749702
                49097d57-6915-4f9e-952a-94eabeb50140
                Copyright ©2011 Allison et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 January 2011
                : 12 July 2011
                Categories
                Research Article

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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