Postpartum evaluation of the role of maternal characteristics and mode of delivery on maternal attachment, anxiety and depression; a study conducted in Turkey

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Abstract

Background and aim:

The primary aim of this study was to compare mother-infant bonding (MIB) in patients who delivered vaginally and with cesarean section (C/S) using the Maternal Attachment Inventory (MAI), Edinburgh Postnatal Depression Scale (EPDS), and Postpartum Specific Anxiety Scale (PSAS) in the Turkish population. The secondary aim was to evaluate the correlations between the MAI, EPDS, and PSAS scores and their association with sociodemographic data.

Method:

A total of 200 patients were divided into two groups. One hundred women who delivered vaginally were included in the vaginal delivery (NVD) group, and 100 who delivered with C/S were included in the C/S group. The demographic data of the subjects, including age, gravidity, and parity, were recorded, and a detailed anamnesis was taken on the day of hospitalization for delivery. The newborns’ sex were also taken into account. All patients were asked to complete the MAI, EPDS, and PSAS at the third-month postpartum control.

Results:

The PSAS score in the NVD group was calculated to be 68.9 ± 9.0, which was significantly higher than the score in the C/S group of 65.0 ± 9.6 ( p = 0.005). However, the MAI and EPDS scores in both groups were calculated to be similar ( p = 0.833 and p = 0.260, respectively). A significant negative correlation was observed between age and the MAI ( r = -0.180, p = 0.011) and between the number of children and the MAI ( r = -0.140, p = 0.048).

Conclusions:

The results of this study, which was conducted using a Turkish cohort, show that maternal age at delivery and the number of children at home had an effect on MIB. Conversely, mode of delivery did not influence MIB in this study population. Multicenter studies with a larger number of subjects are needed to reach a general conclusion regarding the Turkish population. (www.actabiomedica.it)

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Most cited references 27

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Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

J Cox, J. Holden, R Sagovsky (1987)

The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.

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Anxiety and depression in patients with endometriosis: impact and management challenges

Antonio Simone Laganà, Valentina Lucia La Rosa, Agnese Rapisarda … (2017)

Endometriosis is one of the most common gynecological diseases and affects ~10% of women in reproductive age. The most common clinical signs of endometriosis are menstrual irregularities, chronic pelvic pain (CPP), dysmenorrhea, dyspareunia and infertility. Symptoms of endometriosis often affect psychological and social functioning of patients. For this reason, endometriosis is considered as a disabling condition that may significantly compromise social relationships, sexuality and mental health. Considering this point, the aim of this narrative review is to elucidate the impact of anxiety and depression in the management of women with endometriosis. Psychological factors have an important role in determining the severity of symptoms, and women who suffer from endometriosis report high levels of anxiety, depression and other psychiatric disorders. In addition, endometriosis is one of the most important causes of CPP; women with endometriosis suffer from a wide range of pelvic pain such as dysmenorrhea, dyspareunia, nonmenstrual (chronic) pelvic pain, pain at ovulation, dyschezia and dysuria. Several studies have underlined the influence of CPP on quality of life and psychological well-being of women with endometriosis. Data suggest that the experience of pelvic pain is an important component of endometriosis and may significantly affect emotive functioning of affected women. It has been demonstrated that high levels of anxiety and depression can amplify the severity of pain. Further studies are needed to better understand the relationship between psychological factors and perception of pain. Treatment of endometriosis may be hormonal or surgical. Surgery is the primary treatment for more severe forms of endometriosis. There are few data in the literature about the influence of psychological factors and psychiatric comorbidities on the effectiveness of treatments. It is important to evaluate the presence of previous psychiatric diseases in order to select the most appropriate treatment for the patient.

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The Postpartum Specific Anxiety Scale: development and preliminary validation

Victoria Fallon, Jason Christian Grovenor Halford, Kate Mary Bennett … (2016)

Perinatal symptoms of anxiety are increasingly recognised due to their high prevalence and impact. Studies using pregnancy-specific anxiety measures have found that they may predict perinatal outcomes more effectively than general measures. However, no such measure exists to assess anxieties specific to the postpartum. This study aimed to develop and validate a measure (Postpartum Specific Anxiety Scale; PSAS) that accurately represents the specific anxieties faced by postpartum women, using a four-stage methodology: (1) 51 items were generated from interviews conducted with a group of 19 postpartum women at two time points, (2) the scale was reviewed and refined by a diverse expert panel, (3) an online pilot study (n = 146) was conducted to assess comprehensibility and acceptability and (4) an online sample of 1282 mothers of infants up to 6 months old completed the PSAS against a battery of convergent measures. A subsample (n = 262) repeated the PSAS 2 weeks later. The PSAS possessed good face and content validity and was comprehensible and acceptable to postpartum women. PSAS scores were significantly correlated with other measures indicating good convergent validity. Principal component analyses (PCA) revealed a simple four-factor structure. Reliability of the overall scale and individual PSAS factors proved to be good to excellent. A preliminary receiver operating characteristic (ROC) analysis also suggested that the PSAS may be a useful screening tool. The psychometric evidence suggests that the PSAS is an acceptable, valid, and reliable research tool to assess anxieties, which are specific to the postpartum period. Next steps in the iterative validation process are considered for both research and screening purposes.

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Author and article information

Journal

Journal ID (nlm-ta): Acta Biomed

Journal ID (iso-abbrev): Acta Biomed

Title: Acta Bio Medica : Atenei Parmensis

Publisher: Mattioli 1885 (Italy )

ISSN (Print): 0392-4203

ISSN (Electronic): 2531-6745

Publication date (Print): 2022

Publication date (Electronic): 14 March 2022

Volume: 93

Issue: 1

Electronic Location Identifier: e2022011

Affiliations

[1 ] Department of Obstetrics and Gynecology, University of Health Sciences Turkey Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey

[2 ] Department of Obstetrics and Gynecology, University of Health Sciences Turkey Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey

[3 ] Department of Obstetrics and Gynecology, Gazi University Medical Faculty, Ankara, Turkey

[4 ] Department of Psychiatry, Istanbul Aydin University Faculty of Medicine, Istanbul, Turkey

[5 ] Department of Obstetrics and Gynecology, Acibadem Bodrum Medical Center, Mugla, Turkey

Author notes

Correspondence: Nura Fitnat Topbas Selcuki, MD. Address: University of Health Sciences Turkey, Istanbul Hamidiye Etfal Training and Research Hospital, Department of Obstetrics and Gynecology, Kazim Karabekir Pasa, Bahcekoy Cd. No 62 34453 Sariyer Istanbul/Turkey E-mail: fitnat.topbas@ 123456gmail.com https://orcid.org/0000-0002-5749-9987

Article

Publisher ID: ACTA-93-11

DOI: 10.23750/abm.v93i1.12137

PMC ID: 8972870

PubMed ID: 35315397

SO-VID: 982899e8-c7fd-4908-b283-b00a6e766b20

License:

This work is licensed under a Creative Commons Attribution 4.0 International License

History

Date received : 09 August 2021

Date accepted : 20 September 2021

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