Abstract
The Dresden Study on Parenting, Work, and Mental Health (“DResdner Studie zu Elternschaft, Arbeit, und Mentaler Gesundheit”, DREAM) aims to prospectively investigate the relationship between parental work participation, role distribution, stress factors, and their effects on perinatal outcomes and long-term family mental and somatic health in a community sample targeting N = 4,000 individuals, i.e., 2,000 couples, expecting a child and residing in Dresden, Germany (interim sample of N = 1,410 participants, recruitment ongoing). Various questionnaires are completed at four measurement points from pregnancy to 2 years postpartum (prolongation into middle childhood planned). Applying a multi-method approach, long-term endocrinological data (analyses of hair cortisol concentrations and other endogenous hormones, “DREAMHAIR”) and qualitative interview data (regarding gender role attitudes and distribution of domestic work, child care, and paid employment; “DREAMTALK”) are obtained. In this study protocol, the theoretical background, methods, and preliminary results considering sociodemographic characteristics during pregnancy and birth-related factors at 8 weeks postpartum are presented. Additionally, there is a focus on our endocrinological sub-study DREAMHAIR. In this sub-study currently comprising N = 152 participants, i.e., 88 families (recruitment ongoing), we want to gain knowledge on the transgenerational processes of stress regulation and psychopathology in the whole family by analyzing hair cortisol concentrations in both parents and children during the course from pregnancy (or after birth regarding children) to at least 2 years postpartum. By comparing data of the community sample to a clinical sample of mothers with postpartum mental disorders, their children, and their partners during the period between admission and discharge from a mother-baby unit and post-treatment (“DREAMMBU”), the course of mothers' psychopathology, parent-infant interaction, and infant regulation disorders with special regard to long-term endocrine correlates will be examined. With previous studies neglecting the fathers or partners involved, a major advantage of DREAM is the use of a multi-method and multi-level approach by examining the whole family in a longitudinal design. Therefore, the DREAM study will contribute to a better understanding of the role of social, work, and stress factors for mental and somatic health and its long-term endocrine correlates in the natural course of becoming a family.
Highlights
Expecting a child marks a transition involving several physiological, psychological, and structural changes for the individual as well as for the couple
The majority of German women reduces its work participation after giving birth to a child and continues staying at home after paid parental leave runs out 12 months postpartum; and of those women who do return to their jobs, the majority only works part-time (Bundesministerium für Familie Senioren Frauen und Jugend, 2017a)
Short- and long-term consequences of mothers’ longer parental leave and not being employed refer to an unbalanced distribution of domestic work and child care (Buehler and O’Brien, 2011; Schober and Zoch, 2015), unequal wages after re-entry in the labor market (Davies and Pierre, 2005; Bryan and Sevilla-Sanz, 2010), and a delay in their professional career which may result in an increasing dependency on the partner and consolidate a gender gap interfering with gender equality (Barker and Pawlak, 2011; Miani and Hoorens, 2014)
Summary
Expecting a child marks a transition involving several physiological, psychological, and structural changes for the individual as well as for the couple. Evidence regarding the relations between maternal self-reported distress, activity of the HPA axis, and infant outcomes is rare, inconsistent, and mainly stems from studies assessing short-term cortisol (e.g., in saliva: Bosquet Enlow et al, 2017; Van den Bergh et al, 2017). More detailed information about the HPA axis linkage between parents and in parent-child dyads is needed to examine the pathways of transgenerational transmission of long-term regulation of the HPA axis and possible approaches for intervention To close this gap, the current cohort study called Dresden Study on Parenting, Work, and Mental Health (DREAM; “DResdner Studie zu Elternschaft, Arbeit und Mentaler Gesundheit”) together with its sub-studies DREAMHAIR and DREAMTALK combining quantitative questionnaires, qualitative interviews, and long-term endocrine correlates aims to examine the impact of parental work participation, role distributions, and stress factors on family health longitudinally, i.e., during the course from late pregnancy to 2 years postpartum. Considering the complex relationships between prenatal and postnatal psychological distress and longterm cortisol secretion in parents and their offspring, this study will make a significant contribution to the existing literature
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