Abstract
Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants with full-term ones. Seventy seven preterm infants (32 ELBW; 45 VLBW) and 120 full term (FT) infants and their mothers were recruited. At 3 months of corrected age, 5 min of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviors were impaired only in case of comorbidity. ELBW’s mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother–infant interactions and on maternal affective state. Early diagnosis can help to plan supportive interventions.
Highlights
Maternal Depression and Anxiety in the Postnatal Period Postnatal depression has been widely recognized as a significant risk factor for woman’s health, baby’s development and the quality of mother–infant interactions (O’Hara and Swain, 1996; Martins and Gaffan, 2000; Guedeney and Jeammet, 2001; Righetti-Veltema et al, 2002; Beebe et al, 2012; Piteo et al, 2012)
The three groups were homogeneous with relation to most of the variables, except for parity and level of education (Table 1): full term (FT) infants’ mothers, compared to extremely low birth weight (ELBW) and very low birth weight (VLBW) ones, were primiparous in a higher percentage [χ2(2) = 11.495; p = 0.003] and had a higher level of education [F(1,196) = 12.023; p < 0.0005; Bonferroni post hoc: p < 0.0005 and p = 0.003, respectively]
Specific analyses were run to control the effect of maternal parity, years of education and general quotient (GQ) on Edinburgh Postnatal Depression Scale (EPDS), Penn State Worry Questionnaire (PSWQ) and Global Rating Scales (GRS) scores: parity did not show any significant influence, while education and level of development were significantly associated with dependent variables
Summary
Maternal Depression and Anxiety in the Postnatal Period Postnatal depression has been widely recognized as a significant risk factor for woman’s health, baby’s development and the quality of mother–infant interactions (O’Hara and Swain, 1996; Martins and Gaffan, 2000; Guedeney and Jeammet, 2001; Righetti-Veltema et al, 2002; Beebe et al, 2012; Piteo et al, 2012). Postnatal depression and anxiety might have long-term effects both on the mother and on the infant (Kersting et al, 2004; Murray et al, 2011) and literature shows how both depression and anxiety impact on the quality of mother–infant interactions, which appear as less synchronous and coordinated than those of non-depressed or non-anxious mother-infant dyads (Mertesacker et al, 2004; Nicol-Harper et al, 2007; Zelkowitz et al, 2009). Recent literature focused on the cognitive components of anxiety and on the specific worries linked to the perinatal period (Murray et al, 2007; Stein et al, 2012)
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