Couples' psychological adjustment to twin parenthood: mode of conception (spontaneous versus assisted reproduction) and gender differences.

Iva Tendais,Bárbara Figueiredo,Catarina Canário,David A Kenny

doi:10.1017/s1463423618000269

Abstract

To examine whether mode of conception and gender are associated with parents' psychological adjustment across the transition to twin parenthood. There is limited knowledge on the psychological adjustment of couples to twin parenthood during pregnancy and early postpartum, especially for fathers. The available research suggests that first-time mothers of twins conceived by assisted reproduction techniques (ART) may experience lower psychosocial well-being than mothers of spontaneously conceived (SC) twins. A total of 41 couples expecting twins, 25 of whom conceived spontaneously and 16 conceived by assisted reproduction techniques, completed measures of depressive and anxiety symptoms, marital relationship, attitudes to sex, and attitudes to pregnancy and the baby. ART parents showed a decline in marital relationship quality, no changes in attitudes to pregnancy and the baby and no changes in attitudes to sex over the postpartum. In contrast, SC parents did not change their perception of the marital relationship, reported more positive attitudes to pregnancy and the baby, and more positive attitudes to sex over the postpartum. Compared with the other groups (SC mothers and fathers, ART fathers), ART mothers exhibited a higher increase in depressive and anxiety symptoms from pregnancy to postpartum and only anxiety symptoms exhibited a decline trend over the postpartum. These findings suggest that ART parents may experience more psychological difficulties during the transition to twin parenthood than SC parents. ART mothers, in particular, appear to be more at risk of high levels of postpartum depressive symptoms.

Highlights

Twin birth rates have increased worldwide in the last decades, largely due to the increased use of assisted reproduction technology (ART)
The purpose of this study was to examine whether mode of conception and gender are associated with parents’ psychological adjustment across the transition to twin parenthood, taking into account the interdependence of data within couples
In more than a third of cases, at least one of the twins was admitted to a neonatal intensive care unit (NICU) (34.1%) with an average stay of 21.3 days (SD = 24.9)

Summary

Introduction

Twin birth rates have increased worldwide in the last decades, largely due to the increased use of assisted reproduction technology (ART). Parents of twins have to deal repeatedly with several stressful situations. Twins have higher risk of prematurity, low birth weight, and perinatal mortality compared with singletons (Blondel et al, 2002). Twins show poorer neurodevelopmental outcomes than singletons (Lorenz, 2012). To meet the needs of two or more children, parents may experience financial, childcare, and physical and psychological issues (Ellison and Hall, 2003; Choi et al, 2009). The first three months after delivery are a vulnerable period for mothers due to the overload of caregiving tasks and different sleeping and feeding patterns of the twins (Beck, 2002)

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