Postpartum Assessments Research Articles

Prepartum, Postpartum, and Chronic Depression Effects on Newborns

In order to assess the effects of the onset and chronicity of maternal depression on neonatal physiology, eighty pregnant women were assessed for depression during mid-pregnancy (M gestational age = 25.9 weeks) and shortly after delivery. The women were classified as reporting depressive symptoms 1) only during the prepartum assessment; 2) only during the postpartum assessment; 3) during both the prepartum and postpartum assessments; or 4) reporting no depressive symptoms at either the prepartum or the postpartum assessment. Maternal mood and biochemistry were assessed during pregnancy, and the EEG and biochemical characteristics of their 1-week-old infants were assessed shortly after birth. As predicted, the newborns of the mothers with prepartum and postpartum depressive symptoms had elevated cortisol and norepinephrine levels, lower dopamine levels, and greater relative right frontal EEG asymmetry. The infants in the prepartum group also showed greater relative right frontal EEG asymmetry and higher norepinephrine levels. These data suggest that effects on newborn physiology depend more on prepartum than postpartum maternal depression but may also depend on the duration of the depressive symptoms.

Perceptions of the maternal-child clinical rotation: the male student nurse experience.

Although male student nurses have expressed their discomfort with beginning their maternal-child clinical experience, little actually is known about the nature and quality of their experience. To address this gap, a phenomenological study was conducted to investigate the experiences of 8 male student nurses who had completed their maternal-child rotation. Three theme clusters emerged: preconceptions about the maternal-child rotation, enduring the clinical experience, and surviving the clinical rotation. Students began their rotations with mixed feelings (e.g., dread, anxiety, apprehension, unknowing, fear of rejection). Maternal-child nursing was viewed by male students as a woman's domain, in which they were visitors. The students expressed concerns about meeting clinical objectives and personal goals because of their gender and possible misinterpretations of their care. Consequently, they undertook special precautions when performing postpartum assessments. Faculty played a significant role in clients' responses to the students and in providing a supportive learning environment. Faculty need to be cognizant of students' feelings as they plan clinical experiences. Identification of student concerns prior to the experience may be beneficial for enhancing the learning environment.

Alterations in adolescents' sensory taste preferences during and after pregnancy

The purpose of this study was to determine adolescents' preferences during and after pregnancy for foods that differed in fat, sugar, and salt content, components that are associated with much of the flavor in food and, hence, are related to food acceptance. Sensory taste preferences for 16 foods were assessed by 52 white adolescents during the third trimester of pregnancy and again 11-13 months postpartum. The study design was a randomized, incomplete block design. Each subject evaluated the same eight foods at each interview using a 10-cm hedonic scale, which was scored 0 = "dislike extremely" to 10 = "like extremely." Three pairs of foods differed in fat content (e.g., ice cream vs. ice milk), two pairs differed in sugar content, but neither contained a sugar substitute (e.g., peaches in heavy syrup vs. natural juices), and three pairs differed in salt content (e.g., salted vs. unsalted peanuts). Differences in preferences were determined with least-squares analysis of variance. Although preferences for 13 of the 16 foods did not differ between pregnancy and postpartum assessments, whole milk, skim milk, and salted peanuts were ranked significantly higher (p = 0.02, 0.007, and 0.05) during pregnancy. Hedonic scores were higher (p = 0.002 and 0.005) for whole milk over skim at both assessments, but ice cream was not preferred significantly over lower fat frozen products. During pregnancy, but not after, salted peanuts, chips, and crackers were preferred (p = 0.0003, 0.0001, and 0.03) over the unsalted/low-salt products. The adolescents' increased sensory taste preferences for milk and salty snack foods during pregnancy, as well as personal taste preferences, should be recognized by clinicians, and nutrition recommendations should be individualized to enhance compliance.

Defense Style and Adjustment in Interpersonal Relationships

The aim of this study was to determine whether an individual's defense style significantly influences his or her relationship satisfaction in the transition to parenthood. Questionnaire measures of relationship satisfaction and personality (including defense style) were administered in the midtrimester of pregnancy to 157 couples expecting their first child. Follow-up assessments of relationship satisfaction were conducted at 4 and 12 months postpartum. The strongest predictor of current relationship satisfaction for both mothers and fathers was prior relationship satisfaction. In addition, measures of defense style were found to contribute significantly to the prediction of relationship satisfaction at both postpartum assessments. The results support the usefulness of models of defense style for understanding processes of coping and adjustment in normal adults. Methodological issues in the measurement of defense style and gender differences in defense functioning are discussed.

The firstborn's adjustment to the birth of a sibling: a longitudinal assessment.

41 middle-class families were interviewed at 1 month prepartum and 1, 4, 8, and 12 months after the birth of a second child to assess the reaction and adjustment of firstborn children to this event. Family members were also observed in a semistructured play session in order to obtain information concerning changes in familial interaction patterns. A log linear analysis was conducted to fit a hierarchical model to a 2 (child gender) X 2 (infant gender) X 4 (time of measurement relative to birth of infant) X 2 (presence or absence of problematic regressive behavior) X 14 (type of problematic behavior reported) matrix. A model with 2 statistically significant effects was found to fit the observed frequency matrix quite well, goodness-of-fit (GF) chi 2(312, N = 2,296) = 97.47, p less than .99. This model suggests (1) that the type of response displayed by the firstborns varied as a function of time since the birth; that their initial responses were either imitations of the infant or confrontations with the mother or infant, whereas responses at 4 months postpartum were characterized by numerous anxiety behaviors but fewer imitations or confrontations, and later responses were primarily confrontations with the increasingly intrusive and independent infant; and (2) that a greater frequency of problematic behavior was reported by the mothers of same-sex sibling dyads, especially at the 1- and 8-month postpartum assessments. Observational data indicated that mothers dramatically decreased their interactions with the firstborn children over time but that fathers tended to remain relatively stable in their frequencies of interaction.