Positive Maternal Mental Health Research Articles

Perceived pressure to breastfeed negatively impacts postpartum mental health outcomes over time.

Positive maternal mental health is associated with improved outcomes for infants, and yet the consideration of maternal mental health is often neglected in breastfeeding interventions. Breastfeeding interventions typically focus on breastfeeding promotion, and do not always include supports for the mother. This may result in isolated perceived pressure to breastfeed, the mental health impacts of which are not well understood. This mixed-methods, longitudinal study examined whether perceived pressure to breastfeed was associated with depression, suicide ideation, anxiety, birth trauma and stress concurrently and 4 weeks later for postpartum mothers. It also examined qualitative experiences of feeding. Perceived pressure to breastfeed was associated with increased anxiety, stress and birth trauma symptoms four weeks later. Thematic analysis suggested this may be due to difficulties living up to the "breast is best" ideal, believing breastfeeding was part of success as a mother, lack of choices and autonomy in feeding choices for infants and general lack of support. As such it appears we may be doing more harm than good by focusing our interventions for breastfeeding primarily on increasing pressure to breastfeed, and interventions should consider strategies for promoting positive maternal mental health alongside breastfeeding.

Positive maternal mental health during pregnancy and psychiatric problems in children from early childhood to late childhood.

Negative maternal mental health during pregnancy increases the risk of psychiatric problems in children, but research on the potential benefits of positive maternal mental health during pregnancy is scarce. We investigated associations between positive maternal mental health composite score, based on reports of maternal positive affect, curiosity, and social support during pregnancy, and children's psychiatric problems (Child Behavior Checklist) at ages 1.9-5.9 and 7.1-12.1 years among 2636 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study. For each standard deviation higher positive maternal mental health score during pregnancy, total psychiatric problems were 1.37 (95% confidence interval (CI) -1.79,-0.95) t-scores lower in early childhood and 1.75 (95% CI -2.24,-1.26) t-scores lower in late childhood. These associations were independent of covariates and of negative maternal mental health. Total psychiatric problems remained stably lower from early childhood to late childhood in children of mothers with higher positive mental health during pregnancy, whereas they increased in children of mothers with lower positive mental health. Positive maternal mental health in child's late childhood partially mediated the effects of positive maternal mental health during pregnancy on children's psychiatric problems. Supporting positive maternal mental health may benefit mothers and children.

Differential effects of prenatal psychological distress and positive mental health on offspring socioemotional development from infancy to adolescence: ameta-analysis.

The impact of prenatal maternal mental health on offspring socioemotional development is substantial and enduring. Existing literature primarily focuses on the effects of psychological distress during pregnancy, emphasizing adverse child outcomes. Recent studies, however, highlight the unique impact of positive maternal mental health on child outcomes. To elucidate the differential associations of maternal psychological distress and positive mental health during pregnancy with child outcomes, we conducted a systematic literature search and random-effects meta-analyses on studies investigating the associations of prenatal maternal mental health with child socioemotional development. Our analyses, comprising 74 studies with 321,966 mother-child dyads across 21 countries, revealed significant associations of prenatal psychological distress with both adverse and positive child socioemotional outcomes. Notably, the effect sizes for the association of psychological distress with positive child outcomes were smaller compared to adverse outcomes. Positive prenatal mental health, on the other hand, was significantly associated with positive socioemotional outcomes but not adverse outcomes. This meta-analysis highlights the independence of negative and positive prenatal mental health constructs and their distinct relationships with child socioemotional development. The findings underscore the importance of considering the positive spectrum of maternal mental health and developmental outcomes to enhance our understanding of prenatal influences on child development. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335227, identifier CRD42022335227.

Calming the Storm: The Role of Prenatal Counseling in Alleviating Maternal Anxiety

Maternal anxiety is a prevalent concern that can significantly impact the well-being of both mothers and their children. The period surrounding childbirth is often accompanied by heightened stress and anxiety due to the anticipation of labor, concerns about maternal health, and the transition to parenthood. Recognizing the importance of addressing maternal anxiety, prenatal counseling has emerged as a valuable tool in mitigating anxiety levels and promoting positive maternal mental health outcomes. Prenatal counseling plays a crucial role in mitigating maternal anxiety by providing knowledge, developing coping strategies, establishing support networks, and offering early identification and intervention. By addressing maternal anxiety proactively, healthcare providers can promote positive maternal mental health outcomes, enhance mother-infant bonding, and contribute to the overall well-being of families. Investing in prenatal counseling programs and ensuring their accessibility and availability can have a lasting impact on reducing maternal anxiety and fostering a supportive and empowering childbirth experience.

Positive maternal mental health in pregnant women and its association with obstetric and psychosocial factors

ObjectiveTo estimate the frequency of Positive Maternal Mental Health (PMMH) interpretation levels in pregnant women who attended prenatal consultation and to identify their association with obstetric and psychosocial factors.MethodsA cross-sectional study that included pregnant women who attended prenatal care at 12 or more weeks of gestation. The following scales were applied: Positive Mental Health Questionnaire (PMHQ), Goldberg Anxiety and Depression Scale, and Jong Gierveld Loneliness Scale.Results702 pregnant women were evaluated; 634 (90.3%) had flourishing PMMH, and 68 (9.7%) had non-flourishing PMMH. Among the latter, all were at an intermediate level, and none were languishing. Flourishing PMMH was more frequent in adults (91.2%) compared to adolescents (75.0%) and in women with higher education (93.0%) than in those with basic education (83.9%). The PMHQ factors and global score correlated positively with maternal age and negatively with anxiety, depression, emotional, social, and general loneliness. Associated with a higher frequency of non-flourishing PMMH were general loneliness OR:6.32[CI95%:3.38–11.82], social loneliness OR:5.98[CI95%:3.42–10.42], adolescence OR:3.47[CI95%:1.61–7.45], emotional loneliness OR:3.12[1.83–5.32], anxiety OR:2.14[CI95%:1.27–3.60], and depression OR:1.88[CI95%:1.09–3.25]. Less frequently: work occupation outside the home OR:0.41[CI95%:0.24–0.68], technical/technological studies OR:0.22[CI95%:0.08–0.60] and university OR:0.27[CI95%:0.10–0.71]. Preconception consultation, desired pregnancy, cesarean section, and fetal or neonatal death were not associated. In the adjusted model: general loneliness OR:3.02[CI95%:1.10–8.31], social loneliness OR:2.82[CI95%:1.38–5.79] and anxiety OR:1.93[CI95%:1.02–3.67], retained statistical significance.ConclusionNine out of ten pregnant women had flourishing PMMH, and none had languishing PMMH. None of the obstetric factors were associated with non-flourishing PMMH but with general loneliness, social loneliness, and anxiety.

Prospective associations between various prenatal exposures to maternal psychological stress and neurodevelopment in children within 24 months after birth

BackgroundThere is increasing evidence that prenatal exposure to maternal psychological distress may be a factor influencing offspring neurodevelopment, but stress type-dependent effects of maternal psychological distress on offspring neurodevelopment in early childhood have yet to be fully elucidated. Additionally, although positive maternal mental health exerts potential effects in protecting against adverse health outcomes, few investigators have considered the effects of positive maternal mental health on offspring neurodevelopment in early childhood. AimsTo determine the associations between various prenatal exposures to maternal psychological distress and positive life-event experiences and offspring neurodevelopment within 24 months of age. MethodsA total of 4412 mother-child dyads were recruited from the Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal perceived stress, negative life-event stress, positive life-event experiences around the time of conception (i.e., three months prior to and after conception) were assessed at 12–16 gestational weeks, and maternal anxiety and depressive symptoms were assessed at 32–36 gestational weeks. We measured children's neurodevelopment using the Ages and Stages Questionnaire, Third Edition (ASQ-3) at two, six, 12, and 24 months postnatally. We then exploited generalized linear models to estimate the associations between prenatal maternal psychological distress and positive life-event experiences and children's neurodevelopment at the above periods, and generalized linear mixed models were applied to assess the associations between maternal psychological distress and positive life-event experiences and suspected developmental delay (SDD) in children within 24 months after birth based on a longitudinal design. ResultsMaternal perceived stress and negative life-event stress around the time of conception, and anxiety and depressive symptoms during late pregnancy were negatively associated with scores of children's neurodevelopment at two, six, 12, and 24 months of age; while maternal life-event experiences were positively associated with scores of children's neurodevelopment. Longitudinal analysis revealed that higher levels of maternal negative life-event stress and depressive symptoms augmented the risk of SDD in personal-social (OR = 1.435, 1.681). Mothers who experienced higher levels of positive life-event experiences exhibited a reduced risk of SDD in gross motor and personal-social domains (OR = 0.373, 0.350). ConclusionsPrenatal exposure to maternal psychological distress is negatively associated with children's neurodevelopment in early childhood depending upon the type of distress. Maternal positive life-event experiences around the time of conception appeared to present potential benefits for child neurodevelopment.

Positive maternal mental health attenuates the associations between prenatal stress and children's internalizing and externalizing symptoms.

Positive maternal mental health can improve perceptions of stressful situations and promote the use of adaptive coping strategies. However, few studies have examined how positive maternal mental health affects children's development. The aims of this study were to examine the associations between positive maternal mental health and children's internalizing and externalizing symptoms, and to ascertain whether positive maternal mental health moderated the associations between prenatal stress and children's internalizing and externalizing symptoms. This study is based on the Norwegian Mother, Father, and Child Cohort Study (MoBa), and comprised 36,584 mother-child dyads. Prenatal stress was assessed using 41 self-reported items measured during pregnancy. Positive maternal mental health (self-efficacy, self-esteem, and enjoyment) was assessed by maternal report during pregnancy and postpartum. Child internalizing and externalizing symptoms were assessed by maternal report at age 5. Structural equation modeling was used for analysis. Maternal self-efficacy, self-esteem, and enjoyment were negatively associated with internalizing and externalizing symptoms in males and females. The association between prenatal stress and internalizing symptoms in males was stronger at low than at high levels of maternal self-esteem and enjoyment, whereas for females, the association was stronger at low than at high levels of maternal self-esteem and self-efficacy. This study provides evidence of associations between positive maternal mental health and children's mental health, and suggests that higher positive maternal mental health may buffer against the impacts of prenatal stress. Positive maternal mental health may represent an important intervention target to improve maternal-child well-being and foster intergenerational resilience.

Positive maternal mental health during pregnancy and mental and behavioral disorders in children: A prospective pregnancy cohort study.

The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health. Among 3,378 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children's mental and behavioral disorder diagnoses as well, from birth until 8.4-12.8 (Median = 10.2, Interquartile Range 9.7-10.8) years of age. A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 - 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 - 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55-0.86]. These associations were independent of covariates. Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.

Maternal Mental Health under COVID-19 Pandemic in Thailand.

Numerous nations have implemented lockdown measures in response to the COVID-19 pandemic. As a consequence of the lockdown on daily living, social participation, and health service accessibility, vulnerable people, for example, new mothers, may experience an increase in mental health problems. This cross-sectional survey was conducted to investigate the impact of the COVID-19 pandemic lockdown on Thai new mothers and the variables affecting their mental health. The survey data were collected from 903 Thai mothers with infants aged 0–12 months using an online platform and a face-to-face interview questionnaire survey between 17 July and 17 October 2020, during the first nationwide COVID-19 lockdown period. For the final analysis, there were 862 participants who completed all of the questions. The full exploratory analysis was performed by multivariable linear regression to identify the variables influencing maternal mental health. Our study demonstrated that new mothers reported feeling a high extent to some extent of worry (44.9%), increased appetite (40.4%), becoming easily annoyed or irritable (39.1%), and feeling down (33.5%), whereas 82.7% felt able to cope with the first lockdown situation. Practiced relaxation techniques were associated with positive maternal mental health (adjusted β = 1.05, 95% CI 0.57 to 1.52, p < 0.001). The perceived impact of the COVID-19 lockdown was on the household’s ability to pay for rent, to make mortgage payments (adjusted β = −1.59, 95% CI −2.87 to −0.36, p = 0.011), the household’s ability to pay for other essentials, such as utilities and medication (adjusted β = −1.99, 95% CI −3.16 to −0.81, p = 0.001), household crowding after lockdown (adjusted β = −3.46, 95% CI −4.86 to −2.06, p < 0.001), and not going outside or doing outdoor activities (adjusted β = −2.22, 95% CI −3.35 to −1.08, p < 0.001). These impacts were significantly associated with negative mental health. In conclusion, our results emphasize the critical need for continuous monitoring of maternal mental health and developing an effective response strategy and activity for promoting maternal mental health under the stress of repetitive lockdowns and increased economic pressures.

The Influence of Paid Maternity Leave on Postpartum Depression

The prevalence of post-partum depression (PPD) in American mothers continues to remain constant within the United States. This is likely caused by various social determinants of health; namely stress, anxiety, socioeconomic standing and employment benefits. The research done for this paper focuses primarily on the influence of access to paid maternity leave on the rate of PPD as seen across the US and compared against other countries. Paid maternity leave has been identified as a beneficial contributor to positive maternal mental health outcomes following birth and is actively being advocated for within some states throughout the country. Studies conducted reveal how many mothers face stress related to securing employment throughout their leave while most employers that ensure adequate lengths of paid leave see only positive effects – if any – on the company’s overall productivity and profitability. Scholars across the country have come to the common conclusion that a paid leave of at least six months would in turn exhibit positive changes in maternal mental health throughout the lifespan.

Parental Mental Health Associated With Child Overweight and Obesity, Examined Within Rural and Urban Settings, Stratified by Income.

Rural areas experience greater childhood obesity compared with urban areas. Differences in reported physical activity and dietary intake do not fully explain the disparity. The purpose of this study was to examine the association between parental mental health and childhood obesity within urban and rural areas. We used data from the National Survey of Children's Health, 2016, subset to children age 10-17 with available weight data. We stratified the sample by rural and urban settings and examined whether maternal or paternal mental health was associated with child overweight or obesity, accounting for income stratum (low-income: ≤200% federal poverty line; high-income: >200% federal poverty line). We used multivariable analyses to test if associations remained after including covariates of food security, physical activity, and screen time. For the 14,733 children 10-17 years of age in our sample, family income but not rurality was associated with overweight or obesity. Among high-income families, positive mental health of either the mother or the father was associated with lower odds of overweight or obesity. In multivariable models, the association between positive maternal mental health and lower odds of child overweight/obesity persisted after adjustment for family food security, child physical activity, and child screen time. For paternal mental health, the association was not significant after adjusting for these covariates. After stratification by income, there were no differences in childhood overweight/obesity by rurality. Both maternal and paternal mental health are associated with children's weight, though only the maternal association remains after adjusting for covariates.

Positive maternal mental health during pregnancy associated with specific forms of adaptive development in early childhood: Evidence from a longitudinal study-CORRIGENDUM.

Positive maternal mental health during pregnancy associated with specific forms of adaptive development in early childhood: Evidence from a longitudinal study-CORRIGENDUM.

Perinatal Maternal Depressive Symptoms as an Issue for Population Health.

The importance of maternal depression for child outcomes is well established, and impairments in psychosocial function and parenting are as severe in women with high subsyndromal levels of depressive symptoms as they are in women with clinical depression. The author conducted a systematic review that explored the association between maternal depressive symptoms and child neurodevelopmental outcomes, including in neuroimaging studies. The results strongly suggest that the influences of maternal depressive symptoms operate across a continuum to influence child outcomes, implying that maternal depression may appropriately be considered an issue of population health. This conclusion is strengthened by recent findings that reveal distinct influences of positive maternal mental health on parenting and child outcomes. [AJP AT 175: Remembering Our Past As We Envision Our Future April 1851: Fleetwood Churchill, "On the Mental Disorders of Pregnancy and Childbed" "Women affected with any degree of mental derangement during pregnancy are more disposed than others to puerperal mania. But the serious character of these attacks is even deepened by the fact, abundantly established, that the evil is not limited to the mother. Not only may organic diseases of the body be transmitted to the infant, but a predisposition to insanity, thus multiplying the distress in a most alarming ratio." (Am J Psychiatry 1851; 7:297-317 )].

Positive maternal mental health during pregnancy associated with specific forms of adaptive development in early childhood: Evidence from a longitudinal study.

The quality of prenatal maternal mental health, from psychological stress and depressive symptoms to anxiety and other nonpsychotic mental disorders, profoundly affects fetal neurodevelopment. Despite the evidence for the influence of positive mental well-being on health, there is, to our knowledge, no research examining the possible effects of positive antenatal mental health on the development of the offspring. Using exploratory bifactor analysis, this prospective study (n = 1,066) demonstrated the feasibility of using common psychiatric screening tools to examine the effect of positive maternal mental health. Antenatal mental health was assessed during 26th week of pregnancy. The effects on offspring were assessed when the child was 12, 18, and 24 months old. Results showed that positive antenatal mental health was uniquely associated with the offspring's cognitive, language and parentally rated competences. This study shows that the effects of positive maternal mental health are likely to be specific and distinct from the sheer absence of symptoms of depression or anxiety.

Cumulative risk and resilience: The roles of comorbid maternal mental health conditions and community cohesion in influencing food security in low-income households

ABSTRACTMaternal caregivers play a critical role in achieving household food security. This study examines the impact of cumulative risk across multiple systems with respect to household food security. Data were drawn from a nationally representative survey of 2,276 mothers. Using step-wise lagged dependent variable logistic regression models we examine the influence of mental health, household, and neighborhood characteristics on household food security. Households headed by caregivers with a single mental health condition were less likely to be food secure as compared to those without mental health concerns. Comorbid mental health diagnoses compounded the risk, and worsened the odds of achieving food security. Perceived community cohesion emerged as a resilience factor that buffered both individual and community risks to food security. The findings emphasize the link between positive maternal mental health and food security, and suggest that communities may have an important protective role in food security.

Modeling the intergenerational impact of partner abuse on maternal and child function at 24 months post outreach: Implications for practice and policy

ObjectiveMany women are exposed to partner violence during their lifetime which affects mental health and child development. This study revalidates an intergenerational model connecting partner violence to poor functioning for mothers and children using structural equation techniques. MethodA longitudinal design collected data on 300 mother–child pairs. Comparisons between the model, tested at study entry and again at 24 months, are reported. Maternal measures included childhood experiences of abuse, partner abuse, chronic pain, and mental health. The Child Behavior Checklist measured child function. ResultsComparison of both models revealed that maternal chronic pain, maternal mental health, and child witnessing of mother's abuse remain strong predictors of child dysfunction. Maternal social support and self-efficacy are significant predictors of more positive maternal mental health with a conduit effect on child behavior. ConclusionIntimate partner violence directly impacts the victim and also has a secondary impact on the children of abuse victims.

A Structural Equation Model for Parenting Stress in Mothers of Premature Infants

The aim of this study was to develop a model to explain the factors influencing parenting stress in mothers of premature infants, and to verify the appropriateness of the model. The exogenous variables consisted of infant temperament and maternal positive psychological capital (PsyCap). Endogenous variables consisted of parenting efficacy and parenting stress. The participants included 233 mothers of premature infants, with a corrected age under 24 months. Data were collected from March to September 2013, using self-reported questionnaires. The model fit indices suggested that the original hypothesized model adequately fit the data. The final model accounted for 39 % of the variance in parenting stress. Furthermore, we found that parenting stress was directly and indirectly affected by infant temperament, and their mother’s positive PsyCap via parenting efficacy. Premature infant’s negative emotionality was moderately related to higher parenting efficacy and lower parenting stress. Mother’s positive PsyCap directly affected parenting efficacy and parenting, and indirectly affected parenting stress through parenting efficacy. Furthermore, parenting efficacy directly affected parenting stress. These results suggest that nursing strategies based on the parent–child interaction model are needed for promoting positive maternal mental health and parenting efficacy, to reduce parenting stress in mothers of premature infants.

P-1007 - Positive maternal mental health: promoting resilience and wellbeing in perinatal women

Pregnancy and new motherhood are challenging times for families. Promoting positive maternal mental health improves overall health and can prevent mental health problems, which could be detrimental to the woman, her baby, and her family. Since maternal mental well-being is fundamental to the health of her entire family, it is essential that we promote the development and maintenance of positive mental health in perinatal women. Positive mental health is believed to be the optimal way to minimize the risk of mental illness. It is more than the mere absence of mental illness; it also encompasses strategies that will maximize a woman's mental health throughout the perinatal period. Positive mental health also promotes recovery from mental health problems and should be part of every treatment plan. Therefore, it is critical that we help women learn how to deal with the changes associated with pregnancy and new motherhood in ways that promote mental wellbeing and allow them to adapt and enjoy this important period of their life. This presentation explores positive mental health, resilience, optimism, wellbeing, and empowerment in pregnant and postpartum woman. In addition, it provides strategies to promote maternal mental health, specifically, incorporating protective assets for mothers and families. Mental health promotion for pregnant and postpartum women will improve health outcomes for individual women and their families, and will contribute to a more optimistic and thriving society.

A population-based investigation of behavioural and emotional problems and maternal mental health: associations with autism spectrum disorder and intellectual disability

While research indicates elevated behavioural and emotional problems in children with autism spectrum disorders (ASD) and decreased well-being in their parents, studies do not typically separate out the contribution of ASD from that of associated intellectual disabilities (ID). We investigated child behavioural and emotional problems, and maternal mental health, among cases with and without ASD and ID in a large population-representative sample. Cross-sectional comparison of child behavioural and emotional problems and maternal mental health measures among 18,415 children (5 to 16 years old), of whom 47 had an ASD, 51 combined ASD with ID, 590 had only ID, and the remainder were the comparison group with no ASD or ID. The prevalence of likely clinical levels of behavioural and emotional problems was highest among children with ASD (with and without ID). After controlling for age, gender, adversity, and maternal mental health, the presence of ASD and ID significantly and independently increased the odds for hyperactivity symptoms, conduct, and emotional problems. Emotional disorder was more prevalent in mothers of children with ASD (with or without ID). The presence of ASD, but not ID, significantly increased the odds for maternal emotional disorder. As has been found in previous research, positive maternal mental health was not affected by the presence of ASD or ID. ASD and ID are independent risk factors for behavioural and emotional problems. ASD (but not ID) is positively associated with maternal emotional disorder. Approaches to diagnosing hyperactivity and conduct problems in children with ASD may need to be reconsidered.