Emotional reactions of mothers facing premature births: study of 100 mother-infant dyads 32 gestational weeks.

Julien Eutrope,Nathalie Bednarek,Laurence De Mare,Franziska Lempp,Aurore Thierry,Sylvie Nezelof,Catherine Dodane,Anne-Catherine Rolland,Stéphanie Saad,Laurence Aupetit,Daniel Sibertin-Blanc,Kenji Hashimoto

doi:10.1371/journal.pone.0104093

Abstract

ObjectivesThis current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described.MethodsA multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated.ResultsThirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A “depressed” score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery.ConclusionsMothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth.

Highlights

In January 2008, in an article titled, ‘‘Preterm: What Can be Done?’’[1], The Lancet announced a series of three articles series by Robert Goldenberg, to focus on a rising public health issue by studying causes as well as interventions to reduce infant morbidity and mortality, which according to the author was being neglected
In order to compensate for the biases identified, we evaluated the maternal co morbidity using: The HADS (Hospital Anxiety and Depression Scale) [13,14], which is a self-report questionnaire frequently used in international literature, and divided into 2 sub-scales, which are anxiety and depression HADS scales
The EPDS (Edinburgh Post-natal Depression Scale) [16] consists of a self-report questionnaire that tracks postnatal depression and includes 10 items, which we propose to the mother from the fourth week of postpartum

Summary

Introduction

In January 2008, in an article titled, ‘‘Preterm: What Can be Done?’’[1], The Lancet announced a series of three articles series by Robert Goldenberg, to focus on a rising public health issue by studying causes as well as interventions to reduce infant morbidity and mortality, which according to the author was being neglected. According to this editorial, premature births account for 12–13% of births in the United States, and 5–9% in a number of other developed countries. Cases of prematurity are higher in single pregnancies done with in vitro fertilization

Objectives

Methods

Results

Conclusion