Postnatal Experience Research Articles

Prenatal exposure to genocide and subsequent adverse childhood events are associated with DNA methylation of SLC6A4, BDNF, and PRDM8 in early adulthood in Rwanda.

We investigated associations between prenatal genocidal trauma, including maternal rape, and postnatal adverse childhood experiences (ACEs) on DNA methylation of genes associated with the stress response. In a comparative cross-sectional study of 91 Rwandan young adults, categorized by prenatal exposure to genocide and maternal rape, genocide without rape, and unexposed controls, we analyzed DNA methylation from dried blood spots and assessed ACEs and depression and anxiety symptoms at age 24. Prenatal exposure to maternal rape was associated with DNA methylation changes in BDNF and SLC6A4, with the association in BDNF attenuated after including ACE exposure in the model. Genocide exposure without rape was associated with methylation changes in PRDM8 after adjusting for early adversity. Methylation in BDNF and SLC6A4 correlated with depression and anxiety symptoms. These findings underscore the impact of prenatal and postnatal trauma on DNA methylation and mental wellbeing, emphasizing the need for continued support for survivors in the decades after conflict.

Polycystic ovary syndrome: Fertility, prenatal care, pregnancy, and postpartum care.

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous reproductive endocrinopathy affecting 8% to 13% of women in their reproductive years. PCOS has a vast array of clinical manifestations, including metabolic complications, biochemical and phenotypical hyperandrogenism, menstrual cycle dysfunction, and anovulation resulting in infertility. Understanding the relationship of the disorder's pathophysiologic and clinical manifestations is key to successfully managing patients with PCOS. Patients may have different prenatal, perinatal, and postnatal experiences than those who do not have PCOS, and may require a higher level of care or treatment plan adjustments.

Exclusive breastfeeding mitigates the association between prenatal maternal pandemic-related stress and children sleep problems at 24 months of age.

Infant sleep quality is increasingly regarded as an important factor for children long-term functioning and adaptation. The early roots of sleep disturbances are still poorly understood and likely involve a complex interplay between prenatal and postnatal factors. This study investigated whether exclusive breastfeeding during the first 6 months moderated the association between maternal prenatal pandemic-related stress (PRS) and sleep problems in 24-months children born during the COVID-19 pandemic. We also explored the potential contribution of maternal postnatal anxiety in these relations. Seventy-eight infants (50% males) and their mothers provided complete data from birth to 24 months. Between 12 and 48 h from birth, maternal PRS during pregnancy was retrospectively reported as well as maternal anxiety and exclusive breastfeeding. Maternal anxiety and exclusive breastfeeding were also reported at 3 and 6 months after childbirth. Children sleep disturbances were reported at 24 months. Bayesian analyses revealed that maternal PRS was positively associated with sleep problems in children who were not exclusively breastfed from birth to 6 months. Findings add to the growing literature on the lasting impact of early pre- and postnatal experiences on child well-being and development.

Prenatal and Postnatal Opinions and Experiences of Women With Multiple Sclerosis: A Phenomenological Study.

Multiple sclerosis is an irreversible autoimmune disease with significant physical, psychological, and social impacts. Understanding the lived experiences of pregnant women with multiple sclerosis is vital for healthcare professionals to provide better care to these women. This study was designed to explore the lived experiences of pregnant women with multiple sclerosis. A descriptive phenomenological study was conducted at the University of Jaén and included 17 women from different Spanish provinces who were recruited using intentional and snowball sampling methods via national patient associations and social networks. In-depth interviews were conducted, audio-recorded, transcribed, and analyzed using Martins' three steps. The ATLAS.ti 7.0 program was used for data analysis. Two themes and seven subthemes were identified that highlighted the experiences of women in pregnancy with multiple sclerosis: (a) the influence of the disease on the decision to be a mother, with subthemes "The disease determines when to be a mother" and "Considering alternatives to spontaneous pregnancy," and (b) the vision of motherhood with multiple sclerosis, with subthemes "Worry about how the disease can affect the pregnancy," "Worry about how the pregnancy can affect the disease," "Concerns about childbirth," "Difficulty with breastfeeding," and "Worry about the transmission of the disease." Women with multiple sclerosis often face a difficult decision regarding whether to become pregnant. The period of pregnancy and puerperium can be fraught with anxiety, especially in terms of concerns about their ability to raise children. In light of the limited scientific evidence regarding the relationship between multiple sclerosis and pregnancy and the conflicting advice often given to these women, the findings of this study may be used to help improve the quality of the care provided to this population.

Corrigendum: Postnatal social support experiences in primiparous women in Korea: a phenomenological study.

Corrigendum: Postnatal social support experiences in primiparous women in Korea: a phenomenological study.

Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers.

Exclusive breastfeeding (EBF) provides numerous health benefits to children. However, the EBF rate is unsatisfactory among young mothers because they often experience difficulties. Thus, interventions during the postnatal period are imperative to encouraging EBF practices in these populations. Postnatal care (PNC) should be delivered appropriately to ensure a positive postnatal experience; however, there has been little discussion of evidence therein to date. This study investigated the association between proper PNC and EBF practices among young Indonesian mothers. This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. All mothers aged 15-24 years who delivered an infant within the 2 years preceding the survey were included. Mothers were considered to be receiving proper PNC if they started breastfeeding soon after delivery, attended a PNC appointment within 2 days after giving birth, and received breastfeeding counseling and observation during the PNC visit. Approximately 51.6% of infants under 6 months of age born to young mothers (those aged 15-24 years) were exclusively breastfed. Appropriate PNC was received by approximately 24.3% of the total population. The correlation between proper PNC and EBF practices was significant among adolescent mothers aged 15-19 years after an age stratification analysis (odds ratio, 8.22; 95% confidence interval, 1.957-34.524). Maternal age became a noticeable confounder after a risk stratification analysis. Our findings imply the importance of breastfeeding service delivery during the early postnatal period in continuing EBF. Ensuring high PNC quality helps ensure positive postnatal experiences, particularly for adolescent mothers.

Developing a new measure of retrospective body dissatisfaction: links to postnatal bonding and psychological well-being

ABSTRACT Background Pregnancy is a transformative time for women and their bodies, and therefore thoughts and feelings about the body understandably change during this period. While previous research has established the impact of body dissatisfaction on factors like antenatal attachment and maternal mental health, there is a notable gap in understanding its long-term effects on postnatal factors. This is often due to high attrition rates in longitudinal studies. Using retrospective measures could address this issue, however a measure of retrospective pregnant body dissatisfaction has not yet been identified. Aims This paper aimed to create a retrospective measure of pregnancy body dissatisfaction by adapting a previously validated measure. It also aimed to investigate the relationship between retrospective accounts of body dissatisfaction during pregnancy and postnatal anxiety, depression, and bonding. Method Cross-sectional online survey data was collected from women postnatally (N = 404). Findings An exploratory and confirmatory factor analysis identified a two-factor model of retrospective body dissatisfaction, adapted from the Body Understanding Measure for Pregnancy Scale, which was equivalent to two of the original subscales. Using this factor structure, linear regressions demonstrated that higher levels of retrospective pregnant body dissatisfaction were associated with elevated rates of postnatal anxiety and depression and lower bonding scores. Conclusions This study successfully established a measure for assessing retrospective pregnant body dissatisfaction, potentially aiding future research. Additionally, it has highlighted the link between pregnant body dissatisfaction and postnatal levels of depression, anxiety, and bonding. Thus, improving the pregnant bodily experience may have the potential to enhance the postnatal experience.

Maternal experiences of women who had received salutary childbirth education: A descriptive qualitative study.

Childbirth education, underpinned by Salutogenesis, presents a paradigm shift in maternal care. There was no present information about the maternal experiences of women who had received Salutary childbirth education. The present study aimed to deeply explore women's pregnancy, birth and postnatal experiences who attended the 'Salutary Childbirth Education Program' and shed light on the mechanisms of Salutogenesis on maternal health promotion. A descriptive qualitative study was conducted with 15 mothers. The study was conducted during April-October 2023. Data were obtained through semi-structured, in-depth individual longitudinal interviews to cover all maternal periods. A thematic analysis was performed. Women stated that they 'acquired normality oriented perspective' which provides 'attribution of positive meanings to the period' and 'freedom from their risk focus concerns'. Women experienced the naturality of the process and were in the flow. They described that they became 'aware of their internal resources', and gained 'skills for the construction of resources' and 'ability to manage the period'. The 'emotional strength' and 'Investment ability for themselves' in addition to obtained autonomy provided them a feeling of strength to actively engage in their experience. This study explores the experiences of women who participated in the Salutary Childbirth Education Program and describes the mechanisms of the program's components on their experiences. By doing so, it aims to enhance understanding of how healthcare professionals can present effective childbirth education through the use of the Salutogenesis Model. The authors would like to acknowledge and thank the women who attended the education program and were willing to interview.

Doing the month (Zuo Yuezi): postpartum embodied practices and subjectivity among urban white-collar Chinese women

In China, the postnatal bodily experiences of urban white-collar women intricately relate to the tradition of “doing the month” (DTM). The DTM guidelines serve a dual purpose: they aid women in recuperating from postnatal frailty and act as cultural restrictions that govern women’s bodies as bearers of fertility for patrilineal families. This research delves into the postnatal embodied practices of white-collar Chinese women and their articulations of subjectivity during DTM. The findings enrich the theory of embodiment with empirical materials in terms of embodied cultural practice by illustrating how women exhibit embodied subjectivity at the intersections of traditional, modern, and gendered discourses. The findings reveal the affirmative bodily practices of women we interviewed: (i) They astutely employ both beneficial DTM regulations and non-DTM knowledge to support their own body’s recovery. They also procure professional services for enhanced recovery. (ii) They express embodied subjectivity during postnatal breastfeeding, which serves as a way to adapt to motherhood. (iii) From the viewpoint of social relations, mothers can devise coping mechanisms to assert agency during interactions with primary family members concerning breastfeeding and infant care. These findings transcend the literature on women’s body–self relations and extend to the examination of body–self–family relations from a postfeminist standpoint, thereby enriching embodiment theory by suggesting that cultural values and disciplines shape and inform the expression of subjectivity through the body–mind connection during embodied practices.

Early-life maturation of the somatosensory cortex: sensory experience and beyond.

Early life experiences shape physical and behavioral outcomes throughout lifetime. Sensory circuits are especially susceptible to environmental and physiological changes during development. However, the impact of different types of early life experience are often evaluated in isolation. In this mini review, we discuss the specific effects of postnatal sensory experience, sleep, social isolation, and substance exposure on barrel cortex development. Considering these concurrent factors will improve understanding of the etiology of atypical sensory perception in many neuropsychiatric and neurodevelopmental disorders.

Psychosocial and biobehavioral processes underlying the association between prenatal risk factors and child self-regulation.

Over the past few decades, there has been accumulating evidence that prenatal exposure to risk is negatively related to child self-regulation. However, the mechanisms underlying this relationship are unclear. The present study used a multimethod approach to simultaneously examine the mediating role of the developmental trajectories of observed parenting quality (support, stimulation, and structure) and children's functional brain networks (small-worldness) from infancy into the preschool period in a sample of 233 children and their biological mothers. The results revealed a potential sleeper effect: Prenatal exposure to risk was negatively related to child self-regulation during the preschool period, but not during infancy. Parenting quality remained relatively stable over time, whereas small-worldness showed an increase during infancy, followed by a decrease into the preschool age period. These developmental changes did not mediate the relation between prenatal risk and child self-regulation. Prenatal exposure to risk was related to lower levels of maternal support during infancy, but did not affect the development of parenting quality over time. Prenatal risk was also not related to the growth rate of small-worldness in young children. However, the developmental changes in small-worldness predicted individual differences in child self-regulation. These findings suggest that children generally have the potential to benefit from positive postnatal parenting environments, regardless of the levels of prenatal risk. A potential target for intervention efforts based on the current findings might be related to postnatal experiences that impact the development of functional brain networks, which in turn could affect the development of child self-regulation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Men’s experiences of the transition to fatherhood during the first postnatal year: A qualitative systematic review

Introduction: Fatherhood is a significant transition in a man’s life, introducing new challenges. Yet men’s experiences of this period remain poorly understood. Occupational therapists possess skills and knowledge to support individuals during transition. This study explored the experiences of men during the transition to fatherhood over the first postnatal year. Method: Underpinned by an occupational therapy theoretical perspective, a systematic review was conducted. Following searches of databases: AMED, CINAHL, Medline and PsycINFO, qualitative studies meeting selection criteria were retrieved and quality assessed. Data was extracted and synthesised using an established meta-ethnographic approach. Findings: Seven articles were included in the review. Four interconnected themes: (1) A New Occupational Identity, (2) Relationship Changes, (3) Challenges and Impact, (4) Unmet Occupational Needs, and four subthemes: Roles and Responsibilities, and Adjusting Priorities (theme 1); An Emotional Journey and Exhaustion (theme 3) were identified. Discussion: Fathers’ postnatal transitional experiences were reflective of a journey of adjustment and growth. Experiences indicated the requirement for greater support of fathers throughout the antenatal and postnatal transition. Occupational therapists have the skills to work with fathers to balance occupations, manage fatigue and adjust to new roles. Further research should focus on understanding experiences of men in under-represented groups.

Prenatal family income, but not parental education, is associated with resting brain activity in 1-month-old infants

Childhood socioeconomic disadvantage is associated with disparities in development and health, possibly through adaptations in children’s brain function. However, it is not clear how early in development such neural adaptations might emerge. This study examined whether prenatal family socioeconomic status, operationalized as family income and average years of parental education, prospectively predicts individual differences in infant resting electroencephalography (EEG; theta, alpha, beta, and gamma power) at approximately 1 month of age (N = 160). Infants of mothers reporting lower family income showed more lower-frequency (theta) and less higher-frequency (beta and gamma) power. These associations held when adjusting for other prenatal and postnatal experiences, as well as infant demographic and health-related factors. In contrast, parental education was not significantly associated with infant EEG power in any frequency band. These data suggest that lower prenatal family income is associated with developmental differences in brain function that are detectable within the first month of life.

Postnatal social support experiences in primiparous women in Korea: a phenomenological study.

Social support is essential for postpartum well-being, but little is known about the postpnatal social support preferred by primiparous women. This study aimed to comprehensively understand and describe the meaning of postnatal social support experience in primiparous women. The participants were seven primiparous women who were within 1 year after childbirth, recruited through purposive and snowball sampling from an online parenting community. The data were collected through in-depth interviews from November 14 to 28, 2022. Participants were interviewed face-to-face or via phone or online platform, according to their choice. Colaizzi's phenomenological qualitative research method was applied to analyze the meaning of the participants' experience. Five theme clusters and fourteen themes were identified from the data. The five theme clusters are as follows: (1) Shortcomings of the childbirth and postpartum care system I learned through my experience; (2) Government policies focusing on childbirth and child-rearing rather than postpartum recovery; (3) Driving force of postpartum recovery: Shared childbirth process; (4) Childcare on my own; and (5) Conflicted between being a stay-at-home mom and a working mom under inadequate maternity protection policies. Despite postpartum support from the government that was perceived as inadequate, first-time mothers regained confidence and motivation for parenting with the help of family, peers, and social networks. First-time mothers need support from professionals and reliable online communities for postpartum recovery and parenting.

A clinical guideline for the Iranian women and newborns in the postpartum period.

The postpartum is a vital period for women, newborns, spouses, parents, caregivers, and families. Regarding the importance of postpartum care and the lack of comprehensive and up-to-date clinical guidelines in the country of Iran, the postpartum clinical guidelines have been adapted. Cultural adaptation was conducted in three stages. In the first stage, the adaptation team was formed and the process was approved. During the second stage, a systematic literature review was conducted using international databases to identify English-language clinical guidelines published within the last 10 years. Out of 17 guidelines and documents initially selected, 5 guidelines meeting the inclusion and exclusion criteria and published within the last 5 years were chosen following a thorough review by the search team. In the secondary selection, the guidelines were investigated by two subject-matter experts based on AGREE II Checklist, and regarding the high evaluation score obtained by the WHO Recommendations on Postnatal Care of the Mother and Newborn (2022), and the National Institute for Health and Care Excellence (NICE,2021) guideline for postnatal care were selected for cultural adaptation. In the third stage, the opinions of experts from all over the country were collected and scored using the Delphi method, and a final guideline was formulated. The adapted postpartum clinical guideline has offered 56 recommendations. The recommendations are categorized into four major themes including mother care, newborn care, health system and health promotion interventions and post caesarean care. Applying evidence-based recommendations for the care of mothers and babies in the postpartum period will enhance the health system, promote the provision of care after vaginal and caesarean births, and ensure a positive postnatal experience for mothers, fathers, babies, and families.

Demographic and pregnancy-related predictors of postnatal contraception uptake: A cross-sectional study.

To examine the uptake of postnatal contraception (PNC) and experiences of PNC care across a geographical region of England. Cross-sectional online survey. The North East and North Cumbria Integrated Care System (ICS). Women who had completed a pregnancy in the previous 3 years. The uptake of PNC by accessed method(s) and the availability of preferred method(s) is described, and adjusted odds ratios are reported for group differences in uptake by characteristics of interest. Uptake of medically prescribed/administered contraception and uptake of long-acting reversible contraception (LARC) during the postnatal period, and access to preferred PNC methods. Although almost half of respondents (47.1%; n = 1178) reinitiated some form of sexual activity during the postnatal period, only 38.7% (n = 969) of respondents accessed a medically prescribed/administered contraceptive method postnatally, and only 15.5% (n = 389) of respondents accessed a LARC. It is a matter of concern that 18.8% (n = 451) of respondents indicated that they were unable to access their preferred PNC. In multivariate analysis, younger age, lower household income, higher multiparity, operative delivery, unplanned pregnancy and not breastfeeding were significant predictors of higher PNC uptake. The uptake of PNC in this cohort was low, with almost a fifth of women unable to access their preferred method. However, there was some evidence that women belonging to groups perceived to be at risk of rapid repeat pregnancy were more likely to access reliable PNC methods.

Brain Structural Connectivity Guided Vision Transformers for Identification of Functional Connectivity Characteristics in Preterm Neonates.

Preterm birth is the leading cause of death in children under five years old, and is associated with a wide sequence of complications in both short and long term. In view of rapid neurodevelopment during the neonatal period, preterm neonates may exhibit considerable functional alterations compared to term ones. However, the identified functional alterations in previous studies merely achieve moderate classification performance, while more accurate functional characteristics with satisfying discrimination ability for better diagnosis and therapeutic treatment is underexplored. To address this problem, we propose a novel brain structural connectivity (SC) guided Vision Transformer (SCG-ViT) to identify functional connectivity (FC) differences among three neonatal groups: preterm, preterm with early postnatal experience, and term. Particularly, inspired by the neuroscience-derived information, a novel patch token of SC/FC matrix is defined, and the SC matrix is then adopted as an effective mask into the ViT model to screen out input FC patch embeddings with weaker SC, and to focus on stronger ones for better classification and identification of FC differences among the three groups. The experimental results on multi-modal MRI data of 437 neonatal brains from publicly released Developing Human Connectome Project (dHCP) demonstrate that SCG-ViT achieves superior classification ability compared to baseline models, and successfully identifies holistically different FC patterns among the three groups. Moreover, these different FCs are significantly correlated with the differential gene expressions of the three groups. In summary, SCG-ViT provides a powerfully brain-guided pipeline of adopting large-scale and data-intensive deep learning models for medical imaging-based diagnosis.

A prenatal acoustic signal of heat reduces a biomarker of chronic stress at adulthood across seasons.

During development, phenotype can be adaptively modulated by environmental conditions, sometimes in the long-term. However, with weather variability increasing under climate change, the potential for maladaptive long-term responses to environmental variations may increase. In the arid-adapted zebra finch, parents emit "heat-calls" when experiencing heat during incubation, which adaptively affects offspring growth in the heat, and adult heat tolerance. This suggests that heat-call exposure may adjust individual phenotype to hot conditions, potentially compromising individual sensitivity to cool weather conditions. To test this hypothesis, we manipulated individual prenatal acoustic and postnatal thermal experiences during development, and sought to assess subsequent chronic responses to thermal fluctuations at adulthood. We thus measured heterophil to lymphocyte (H/L) ratios in adults, when held in outdoor aviaries during two summers and two winters. We found that birds exposed to heat-calls as embryos, had consistently lower H/L ratios than controls at adulthood, indicative of lower chronic stress, irrespective of the season. Nonetheless, in all birds, the H/L ratio did vary with short-term weather fluctuations (2, 5 or 7days), increasing at more extreme (low and high) air temperatures. In addition, the H/L ratio was higher in males than females. Overall, while H/L ratio may reflect how individuals were being impacted by temperature, heat-call exposed individuals did not show a stronger chronic response in winter, and instead appeared more resilient to thermal variability than control individuals. Our findings therefore suggest that heat-call exposure did not compromise individual sensitivity to low temperatures at adulthood. Our study also reveals that prenatal sound can lead to long-term differences in individual physiology or quality/condition, as reflected by H/L ratios, which are consistent with previously-demonstrated reproductive fitness differences.

Limited bedding and nesting increases ethanol drinking in female rats

Prenatal opioid exposure (POE) and postnatal adverse experiences are early life adversities (ELA) that often co-occur and increase problematic alcohol (EtOH) drinking during adolescence. We investigated the relationship between POE, postnatal adversity, and adolescent EtOH drinking in rats. We also sought to determine whether ELAs affect alpha-adrenoceptor density in the brain because the noradrenergic system is involved in problematic alcohol drinking and its treatment. We hypothesized that the combination of POE and postnatal adversity will increase alcohol drinking in rats compared to rats with exposure to either adversity alone or to control. We also predicted that POE and postnatal adversity would increase α1-adrenoceptor density and decrease α2-adrenoceptor density in brain to confer a stress-responsive phenotype. Pregnant rats received morphine (15 mg/kg/day) or saline via subcutaneous minipumps from gestational day 9 until birth. Limited bedding and nesting (LBN) procedures were introduced from postnatal day (PD) 3-11 to mimic early life adversity-scarcity. Offspring rats (PD 31-33) were given opportunities to drink EtOH (20 %, v/v) using intermittent-access, two-bottle choice (with water) procedures. Rats given access to EtOH were assigned into sub-groups that were injected with either yohimbine (1 mg/kg, ip) or vehicle (2 % DMSO, ip) 30 min prior to each EtOH access session to determine the effects of α2-adrenoceptor inhibition on alcohol drinking. We harvested cortices, brainstems, and hypothalami from EtOH-naïve littermates on either PD 30 or PD 70 and conducted radioligand receptor binding assays to quantify α1- and α2-adrenoceptor densities. Contrary to our hypothesis, only LBN alone increased EtOH intake in female adolescent rats compared to female rats with POE. Neither POE nor LBN affected α1- or α2-adrenoceptor densities in the cortex, brainstem, or hypothalamus of early- or late-aged adolescent rats. These results suggest a complex interaction between ELA type and sex on alcohol drinking.

Prenatal Experiences and Desires With Early Intervention for Families of Children With Down Syndrome

Part C early intervention (EI) starts no earlier than birth, even with a prenatal diagnosis resulting in automatic eligibility. Despite other early home visiting programs beginning prenatally and the increasing likelihood of uncovering certain diagnoses prenatally, pregnant families cannot access EI. This study sought to understand families’ perspectives on their desire for prenatal EI and how EI could support them. Seventeen primarily White non-Hispanic mothers with a prenatal diagnosis of Down syndrome shared their prenatal experiences through retrospective, qualitative interviews. Three themes emerged: (1) prenatal period as a time to connect to EI, (2) different families, different prenatal desires, and (3) postnatal EI experiences, prenatal EI hopes. Families saw benefits to starting prenatally to enroll in and understand EI, and prepare for their baby’s arrival through individualized outcomes. Families appreciated their postnatal EI and envisioned similar supports prenatally. Participants’ shared experiences are discussed in relation to pre- and postnatal EI.