Prenatal Experience Research Articles

The psychological portrait of pregnant women with several complications of multiple pregnancy

BACKGROUND: Multiple pregnancies are high-risk pregnancies from both an obstetric and a psychological point of view.
 AIM: The aim of this study was to identify the features of prenatal experiences of women carrying multiple pregnancies and to determine the influence of several complications of multiple pregnancy on prenatal experience.
 MATERIALS AND METHODS: The study involved 80 individuals aged 19 to 43 years, at a gestational age of 21 to 39 weeks, carrying twins. The patients were divided into five groups by clinical diagnosis and were asked to complete psychodiagnostic questionnaire. The answers to the questions suggested both a quantitative assessment and a qualitative description of their experiences.
 RESULTS: We revealed some differences between the study groups in the frequency of manifestations of different psychological elements of the mothers gestational dominant. Some trends were also found for differences between the groups in terms of prenatal attachment rates. An analysis of pregnant womens descriptions of their ideas about the unborn children and communication with them showed that there were qualitative differences between the groups in the following: ideas about the characters of the unborn children, actual thoughts about them and thoughts about them after delivery, and features of the mothers communication with them in several emotional conditions. The data obtained allowed for describing the psychological portrait of pregnant women with several complications of multiple pregnancy.
 CONCLUSIONS: Depending on the type of multiple pregnancy complications, there are specific psychological experiences associated with pregnancy, future maternity and an emotional bond with the unborn children. Moreover, these experiences influence the behavior of pregnant women and their communication with other people and medical staff.

The Role of Maternal Perceived Social Support on the Relation Between Prenatal Depressive Symptoms and Labor Experience

Abstract. Background: Depression during pregnancy is a severe risk factor for negative outcomes in women and children. In particular, prenatal symptoms of depression are linked to a more complicated labor experience, characterized by more painful labor and more frequent recourse to epidural analgesia and/or oxytocin. Although this link is evident, less is known about possible mediators of this relationship. Aims: This study investigated the mediating role of perceived maternal social support on the relationship between prenatal maternal depression and labor experience. Methods: Participants were 152 Italian nulliparous women ( Mage = 31.68 years, SD = 4.94). Data were collected at two different times: T1 (at week 30–33 of gestation) women completed the Beck Depression Inventory and the Maternal Social Support Scale; T2 (at childbirth) clinical data regarding labor was registered from hospital records (duration of labor in hours and administration of oxytocin and epidural analgesia in hours). Results: The Structural Equation Modeling showed that prenatal symptoms of depression are linked to a more complicated labor experience (β = .31, p < .001). However, the quality of the maternal social support can mediate this relationship (indirect effect: β = .17, p < .000). Limitations: The complexity of the proposed model, the characteristics of the sample, the variables investigated, and the questionnaires used are discussed. Conclusion: The perception of having a good social network is an important predictor of women’s health in the transition to motherhood, decreasing the negative effect of maternal prenatal depressive symptoms on the quality of women’s labor experience.

Neurodevelopmental Preparedness for Language in the Neonatal Brain

Neonates show broad-based, universal speech perception abilities, allowing them to acquire any language. Moreover, an increasing body of research shows that prenatal experience with speech, which is a low-pass signal mainly preserving prosody, already shapes those abilities. In this review, we first provide a summary of the empirical evidence available today on newborns’ universal and experience-modulated speech perception abilities. We then interpret these findings in a new framework, focusing on the role of the prenatal prosodic experience in speech perception development. We argue that the chronological sequence of infants’ experience with speech, starting before birth with a low-pass filtered signal and continuing with the full-band signal after birth, sets up the prosodic hierarchy and a cascade of embedded neural oscillations as its brain correlate, laying the foundations for language acquisition. Prosody, constituting infants’ very first experience with language, may thus play a fundamental role in speech perception and language development.

Coming To: Consciousness and Natality in Early Modern England

Coming To: Consciousness and Natality in Early Modern England

Effectiveness Analysis of a Psychosocial Guidance System in Maternity Clinics

Prenatal stress and early childhood experiences of psychosocial stress can have lifelong health consequences for affected children. Despite the existence of various support services, these services are not always utilized well, especially by families who have a high need for support. The intervention “Babylotse” [engl. Baby pilot] consists of a screening system to connect stressed families with various help settings, according on the needs of the fam-ily. The present quasi-experimental study investigated the effectiveness of this intervention by examining the children’s quality of life one year after taking part in the intervention. The physical development of N = 129 children, as well as the social and living space of the family, were examined, by a nurse at the family’s homes. Parents were interviewed beforehand about their living situation on the phone. There were no significant differ-ences between the children in the intervention group consisting of psychosocial significant stressed families ac-cording to the screening and the control group consisting of families not burdened by psychosocial stress, which suggests the positive effect of the intervention by making up for the existing deficits.

The Role of COVID-19, Race and Social Factors in Pregnancy Experiences in New York State: The CAP Study

Given that New York State’s (NYS) was the first epicenter of the COVID-19 pandemic in the United States (US), we were interested in potential racial/ethnic differences in pregnancy-related experiences among women pregnant during versus prior to the pandemic. We surveyed 1,525 women (18–44 years) proportionate to geographic and sociodemographic distribution between June 9, 20 and July 21, 20. We carried out bivariate analysis of various social and pregnancy-related factors by racial/ethnic identity (White, Black, Hispanic) and binary logistic and linear regression assessing the association between race/ethnicity, pregnancy prior to/during the pandemic, demographic characteristics, health and social wellbeing, and employment as an essential worker with pregnancy-related healthcare delays and changes. Overall, Black and Hispanic women were significantly more likely to experience a host of negative prenatal and postpartum experiences. In general, multivariate analyses revealed that individuals who were pregnant during the pandemic, lived in NYC, participated in social welfare programs, lacked health insurance, and/or were essential workers were more likely to report delays in prenatal and postpartum care and/or more changes/negative experiences. In light of previous evidence of racial disparities in birth experiences, the higher rates of negative pregnancy/birth-care and postpartum/newborn-care experiences among Black and Hispanic women in bivariate analysis warrant further inspection given that their aggregation for multivariate analysis may have obscured differences at the level of individual events. Findings support continued efforts for universal health insurance and improved social welfare programs. Guidelines are needed to protect essential workers’ access to health services, particularly related to pregnancy given the time-sensitive nature of this care. Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1997893 .

Early life adoption shows rearing environment supersedes transgenerational effects of paternal stress on aggressive temperament in the offspring

Prenatal experience and transgenerational influences are increasingly recognized as critical for defining the socio-emotional system, through the development of social competences and of their underlying neural circuitries. Here, we used an established rat model of social stress resulting from male partner aggression induced by peripubertal (P28-42) exposure to unpredictable fearful experiences. Using this model, we aimed to first, characterize adult emotionality in terms of the breadth of the socio-emotional symptoms and second, to determine the relative impact of prenatal vs postnatal influences. For this purpose, male offspring of pairs comprising a control or a peripubertally stressed male were cross-fostered at birth and tested at adulthood on a series of socio-emotional tests. In the offspring of peripubertally stressed males, the expected antisocial phenotype was observed, as manifested by increased aggression towards a female partner and a threatening intruder, accompanied by lower sociability. This negative outcome was yet accompanied by better social memory as well as enhanced active coping, based on more swimming and longer latency to immobility in the forced swim test, and less immobility in the shock probe test. Furthermore, the cross-fostering manipulation revealed that these adult behaviors were largely influenced by the post- but not the prenatal environment, an observation contrasting with both pre- and postnatal effects on attacks during juvenile play behavior. Adult aggression, other active coping behaviors, and social memory were determined by the predominance at this developmental stage of postnatal over prenatal influences. Together, our data highlight the relative persistence of early life influences.

Awareness of maternal stress, consequences for the offspring and the need for early interventions to increase stress resilience.

Experimental and clinical studies suggest that prenatal experiences may influence health trajectories up to adulthood and high age. According to the hypothesis of developmental origins of health and disease exposure of pregnant women to stress, nutritional challenges, infection, violence, or war may "program" risks for diseases in later life. Stress and anxieties can exist or be provoked in parents after fertility treatment, after information or diagnosis of fetal abnormalities and demand simultaneous caring concepts to support the parents. In vulnerable groups, it is therefore important to increase the stress resilience to avoid harmful consequences for the growing child. "Enriched environment" defines a key paradigm to decipher how interactions between genes and environment change the structure and function of the brain. The regulation of the fetal hippocampal neurogenesis and morphology during pregnancy is one example of this complex interaction. Animal experiments have demonstrated that an enriched environment can revert consequences of stress in the offspring during critical periods of brain plasticity. Epigenetic markers of stress or wellbeing during pregnancy might even be diagnosed by fragments of placental DNA in the maternal circulation that show characteristic methylation patterns. The development of fetal senses further illustrates how external stimulation may impact individual preferences. Here, we therefore not only discuss how maternal stress influences cognitive development and resilience, but also design possibilities of non-invasive interventions for both mothers and children summarized and evaluated in the light of their potential to improve the health of future generations.

Knowledge of Biobehavioral Organization Can Facilitate Better Science: A Review of the BioBehavioral Assessment Program at the California National Primate Research Center.

Simple SummaryThe BioBehavioral Assessment (BBA) Program was established in 2001 at the California National Primate Research Center to provide quantitative information on rhesus monkeys’ “intrinsic characteristics.” These characteristics such as temperament and stress responsiveness affect many aspects of an animal’s functioning and can be used to better manage the colony, and to select animals that are more homogeneous for research studies. Here, we review the BBA Program and describe how others have used this information in the design of their studies. We also describe results of studies aimed at understanding what experiences, both prenatal (e.g., exposure to stress) and postnatal (such as rearing), contribute to variation in intrinsic characteristics. The use of data such as these to identify subgroups of individuals with a greater risk for health-related outcomes is an animal model equivalent of a new trend in medicine, namely, precision medicine. Use of BBA data can also lead to a reduction in the number of animals needed in experimental studies.Animals vary on intrinsic characteristics such as temperament and stress responsiveness, and this information can be useful to experimentalists for identifying more homogeneous subsets of animals that show consistency in risk for a particular research outcome. Such information can also be useful for balancing experimental groups, ensuring animals within an experiment have similar characteristics. In this review, we describe the BioBehavioral Assessment Program at the California National Primate Research Center, which, since its inception in 2001, has been providing quantitative information on intrinsic characteristics to scientists for subject selection and balancing, and to colony management staff for management purposes. We describe the program and review studies relating to asthma, autism, behavioral inhibition, etc., where the BBA Program was used to select animals. We also review our work, showing that factors such as rearing, ketamine exposure, and prenatal experience can affect biobehavioral organization in ways that some investigators might want to control for in their studies. Attention to intrinsic characteristics of subject populations is consistent with the growing interest in precision medicine and can lead to a reduction in animal numbers, savings in time and money for investigators, and reduced distress for the animals.

Analysis of Maternal Prenatal Weight and Offspring Cognition and Behavior: Results From the Promotion of Breastfeeding Intervention Trial (PROBIT) Cohort

Prenatal experiences can influence fetal brain development. To examine associations of maternal prenatal body mass index (BMI) with cognition and behavior of offspring born full-term. This cohort study examined follow-up data from a breastfeeding promotion intervention at 31 hospitals and affiliated polyclinics in the Republic of Belarus. Participants included 11 276 children who were evaluated from birth (1996-1997) to adolescence (2017-2019), with maternal BMI information available in prenatal medical records. Maternal BMI, calculated as weight in kilograms divided by height in meters squared, after 35 weeks gestation; secondary analyses examined maternal BMI at other time points and paternal BMI. Trained pediatricians assessed child cognition with the Wechsler Abbreviated Scales of Intelligence (WASI) at 6.5 years and the computerized self-administered NeuroTrax battery at 16 years, both with an approximate mean (SD) of 100 (15). Parents and teachers rated behaviors at 6.5 years using the Strengths and Difficulties Questionnaire (SDQ, range 0-40). Mixed-effects linear regression analyses corrected for clustering, adjusted for the randomized intervention group and baseline parental sociodemographic characteristics, and were considered mediation by child BMI. Among 11 276 participants, 9355 women (83%) were aged 20 to 34 years, 10 128 (89.8%) were married, and 11 050 (98.0%) did not smoke during pregnancy. Each 5-unit increase in of maternal late-pregnancy BMI (mean [SD], 27.2 [3.8]) was associated with lower offspring WASI performance intelligence quotient (IQ) (-0.52 points; 95% CI, -0.87 to -0.17 points) at 6.5 years and lower scores on 5 of 7 NeuroTrax subscales and the global cognitive score at 16 years (-0.67 points; 95% CI, -1.06 to -0.29 points). Results were similar after adjustment for sociodemographic characteristics, pregnancy complications, and paternal BMI and were not mediated by child weight. Higher late pregnancy maternal BMI was also associated with more behavioral problems reported on the SDQ by teachers but not associated with parent-reported behaviors (externalizing behaviors: 0.13 points; 95% CI, 0.02 to 0.24 points; and total difficulties: 0.14 points, 95% CI, -0.02 to 0.30 points). Results were similar for maternal BMI measured in the first trimester or postpartum. In contrast, higher 6.5-year paternal BMI was associated with slightly better child cognition (WASI verbal IQ: 0.42 points; 95% CI, 0.02 to 0.82 points; NeuroTrax executive function score: 0.68 points; 95% CI, 0.24 to 1.12 points) and fewer teacher-reported behavioral problems (total difficulties: -0.29 points; 95% CI, -0.46 to -0.11 points). This cohort study supports findings from animal experiments and human observational studies in settings with higher maternal BMI and obesity rates. Higher maternal prenatal BMI may be associated with poorer offspring brain development, although residual confounding cannot be excluded.

Patient Satisfaction with Virtual-Based Prenatal Care: Implications after the COVID-19 Pandemic.

ObjectiveThe objective of this study was to identify factors related to satisfaction with virtual visits during pregnancy in an effort to prioritize intervention targets for pregnant women during the COVID-19 pandemic.MethodsThe study relied on data obtained from pregnant women (N = 416) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to November 22, 2020. Using a cross-sectional design, this study examined factors including COVID-19 related experiences and prenatal care changes in association with patient satisfaction of virtual prenatal care.ResultsOverall, women reported being very or extremely satisfied (27.9%) or moderately satisfied (43.5%) with their virtual prenatal experiences, however, 89.9% indicated a preference for in-person care under non-pandemic conditions. Those who completed the survey further into the pandemic were less satisfied with virtual prenatal care (β = − 0.127, p < 0.01). After accounting for this and other sociodemographic characteristics, COVID-19 pregnancy worries (β = − 0.226, p < 0.001) and the number of prenatal care changes due to the pandemic (β = − 0.137, p < 0.01) were associated with lower satisfaction.ConclusionOur findings demonstrate general satisfaction with virtual visits among pregnant women in this study although in general women would prefer in-person care if it weren’t for a pandemic. Women worried about the impact of pandemic on their pregnancy, as well as those experiencing transitions in their prenatal care may need more information and reassurance. Additional studies are needed to understand the unmet needs through virtual care compared to in-person care.

Effects of maternal mental health on prenatal movement profiles in twins and singletons.

Prenatal experiences, including maternal stress, depression and anxiety, form crucial building blocks affecting the maturation of the foetal central nervous system. Previous research has examined foetal movements without considering effects of maternal mental health factors critical for healthy foetal development. The aim of this research is to assess the effects of maternal mental health factors on foetal twin compared with singleton movement profiles. We coded foetal touch and head movements in 56 ultrasound scans, from a prospective opportunity sample of 30 mothers with a healthy pregnancy (mean gestational age 27.8weeks for singleton and 27.2 for twins). At the ultrasound scan appointment, participants completed questionnaires assessing their stress, depression and anxiety. Maternal depression increased foetal self-touch significantly. In foetal twins, maternal stress significantly decreased and maternal depression significantly increased other twin touch. Maternal mental health factors affected the head movements of twins significantly more than singletons, with maternal depression decreasing head movement frequency for twins significantly. These results indicate that maternal mental health might have an impact on types of body schemata formed in utero, in twin compared with singleton pregnancies. Future research needs to examine whether these prenatal effects affect postnatal differences in body awareness.

The effect of a natural disaster on handgrip strength in prepubertal Indian children exposed to a severe cyclone during the prenatal and early postnatal growth

Natural disasters (NDs) experienced by women and their children during prenatal and infant growth may have long-lasting effects on offspring’s development. Handgrip strength (HGS) is one of the measures of muscular strength and an indicator of health status. This study compared HGS in children exposed to cyclone Aila in India during their prenatal and infant growth compared to a control group from a non-affected, adjacent area. The total sample involved 444 boys and 423 girls aged 7–9 years, categorised into 3 groups: prenatally exposed to Aila, exposed to Aila in infancy, and the control group, non-exposed to Aila. Results revealed that prenatally exposed children of both sexes had significantly lower HGS than the controls (at least, p < 0.001 in boys; p < 0.05 in girls). On the other hand, the postnatally exposed boys, but not the girls, showed lower HGS than the controls. A significant effect of a group factor (ND exposure) on HGS was observed even after controlling for confounding variables (age, height, BMI, birth weight, gestational age; at least, p < 0.05). Our findings indicate that prenatal or early postnatal experience of a ND may have association with impaired HGS in prepubertal children.

1064 Patient satisfaction with telehealth visits: a contemporary study in the obstetrical population

In light of the COVID-19 pandemic, clinic visits have been transitioned to telehealth encounters. Current evidence has shown that the quality of telehealth visits compared to in-person visits have had similar health outcomes and patient satisfaction. We aim to gain an understanding of patient experience, perspective and satisfaction with telehealth visits at our institution in the obstetrical population. A cross-sectional survey assessing patient satisfaction was conducted among prenatal patients who received telehealth care at our outlaying clinics (conducted over the phone by providers and recently established to decrease person-to-person interaction in light of the COVID-19 pandemic). A validated satisfaction survey was conducted (15 questions using a 5-point Likert scale designed to gauge patient experience, perspective and satisfaction). Questions aim to measure convenience of visit, degree in which clinical/medical issues are addressed, concerns about privacy, preference over in-person prenatal visits, and overall satisfaction. A total of 232 patients were called; 138 chose to participate, 23 declined, and 71 were not reached. Results are summarized in Tables. The majority of patients expressed that their telehealth prenatal visit was just as good as an in-person visit, that their concerns and questions were clearly communicated to their providers, and that their condition or treatment were well explained. Additionally, the majority of patients reported that the visit was convenient, while saving them money and time. However, 71% of patients would still rather have an in-person clinic visit than use telehealth, despite being overall satisfied with their telehealth visit. Unsatisfied subjects reported less benefit in travel time, money savings and were less likely to recommend their telehealth experience to other patients (Table 2). Patients reported high satisfaction rates in their telehealth prenatal experience with additional benefits of saving time and money. It appears however, they still desired to see their providers in person for their prenatal care.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The origins and development of speech envelope tracking during the first months of life

When humans listen to speech, their neural activity tracks the slow amplitude fluctuations of the speech signal over time, known as the speech envelope. Studies suggest that the quality of this tracking is related to the quality of speech comprehension. However, a critical unanswered question is how envelope tracking arises and what role it plays in language development. Relatedly, its causal role in comprehension remains unclear, as some studies have found it to be present even for unintelligible speech. Using electroencephalography, we investigated whether the neural activity of newborns and 6-month-olds is able to track the speech envelope of familiar and unfamiliar languages in order to explore the developmental origins and functional role of envelope tracking. Our results show that amplitude and phase tracking take place at birth for familiar and unfamiliar languages alike, i.e. independently of prenatal experience. However, by 6 months language familiarity modulates the ability to track the amplitude of the speech envelope, while phase tracking continues to be universal. Our findings support the hypothesis that amplitude and phase tracking could represent two different neural mechanisms of oscillatory synchronisation and may thus play different roles in speech perception.

Applying Interdisciplinary Frameworks to Study Prenatal Influences on Child Development.

Modern developmental science is informed by several shared principles and adopts a lifespan approach that goes from infancy to senescence. Increasingly, disciplines outside psychology are adopting research frameworks (e.g., fetal origins, developmental origins of health and disease, first 1000 days) that prioritize prenatal experience as a driver of children's long-term health and developmental outcomes. Despite originating in medical literatures, these new frameworks share many of the core tenets of modern developmental theories. However, they also raise new questions and provoke a broader consideration of developmental influences, outcomes, and contexts. In this article, we describe these frameworks and consider how they align with, differ from, and inform modern developmental science.

Infancy studies come of age: Jacques Mehler's influence on the importance of perinatal experience for early language learning

In this paper, we pay homage to Jacques Mehler's empirical and theoretical contributions to the field of infancy studies. We focus on studies of the ability of the human fetus and newborn to attend to, learn from, and remember aspects of the environment, in particular the linguistic environment, as a part of an essential dynamic system of early influence. We provide a selective review of Mehler's and others' studies that examined the perinatal period and helped to clarify the earliest skills and predilections that infants bring to the task of language learning. We then highlight findings on newborns' perceptual skills and biases that motivated a shift in researchers' focus to fetal learning to better understand the role of the maternal voice in guiding newborns' speech perception. Finally, we point to the inspiration drawn from these perinatal approaches to more full-scale empirical treatments of how prenatal experience and behavior have come to be recognized as essential underpinnings to the earliest mental architectures of human cognition.

Prenatal maternal psychological distress and fetal developmental trajectories: associations with infant temperament.

Associations between prenatal maternal psychological distress and offspring developmental outcomes are well documented, yet relatively little research has examined links between maternal distress and development in utero, prior to postpartum influences. Fetal heart rate (FHR) parameters are established indices of central and autonomic nervous system maturation and function which demonstrate continuity with postnatal outcomes. This prospective, longitudinal study of 149 maternal-fetal pairs evaluated associations between prenatal maternal distress, FHR parameters, and dimensions of infant temperament. Women reported their symptoms of psychological distress at five prenatal visits, and FHR monitoring was conducted at the last three visits. Maternal report of infant temperament was collected at 3 and 6 months of age. Exposure to elevated prenatal maternal psychological distress was associated with higher late-gestation resting mean FHR (FHRM) among female but not male fetuses. Higher late-gestation FHRM was associated with lower infant orienting/regulation and with higher infant negative affectivity, and these associations did not differ by infant sex. A path analysis identified higher FHRM as one pathway by which elevated prenatal maternal distress was associated with lower orienting/regulation among female infants. Findings suggest that, for females, elevated maternal distress alters fetal development, with implications for postnatal function. Results also support the notion that, for both sexes, individual differences in regulation emerge prenatally and are maintained into infancy. Collectively, these findings underscore the utility of direct assessment of development in utero when examining if prenatal experiences are carried forward into postnatal life.

Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study

BackgroundTrauma, natural and man-made catastrophic events can be predictors of postpartum psychological distress. In a public health response due to coronavirus disease 2019 outbreak, the Italian government imposed a lockdown from March 9 to May 3. This extraordinary situation may have been challenging for maternal psychological health. The aim of this study was to investigate the prevalence of depressive and post-traumatic stress symptoms in women giving birth during the Covid-19 pandemic and its associations with quarantine measures, obstetrical factors, and relational attachment style.MethodsWomen who gave birth in a high-volume obstetric/gynaecological medical centre located in an epidemic area during the Covid-19 pandemic (March 8 to June 15) were asked to complete an online survey about their childbirth experience and the perceived effect of the pandemic. The Edinburgh Postnatal Depression Scale (EPDS), the Impact of Event Scale-Revised (IES-R), and the Relationship Questionnaire (RQ) were administered to assess levels of postpartum depressive and post-traumatic stress symptoms (PTSS) and relational style of attachment, respectively. Multivariate analysis was applied to identify associations between quarantine measures, childbirth experience, attachment style, and EPDS and IES-R scores.ResultsThe survey was completed by 163 women (response rate 60.8%). The prevalence of depressive symptoms was 44.2% (EPDS cut-off score ≥ 11) and the PTSS rate was 42.9% (IES-R cut-off score ≥ 24). Dismissive and fearful avoidant attachment styles were significantly associated with the risk of depression and PTSS, respectively. Perceived pain during birth was a risk factor for postpartum depression. Perceived support provided by healthcare staff was a protective factor against depression and PTSS. Another protective factor against PTSS was quiet on the ward due to the absence of hospital visitors.ConclusionThis study reports a high prevalence of postpartum depressive and PTSS in women who gave birth during the Covid-19 pandemic. Postnatal psychological distress seemed to be associated more with the prenatal experience and other individual factors than with the pandemic hospital restrictions. Early detection during pregnancy of an insecure attachment style is fundamental to provide targeted preventive and therapeutic psychological interventions.

Breastfeeding self-efficacy in Asia and Pacific: Scoping review

Background &amp; Aim: Breastfeeding self-efficacy refers to a mother’s perceived ability to breastfeed her new infant and is a salient variable in breastfeeding duration. This study aimed to review the current state of knowledge, including the predictors and interventions, and discuss relevant findings and gaps in the breastfeeding self-efficiency theory. Methods &amp; Materials: Scoping review of peer-reviewed articles between the years of 2009-2019. Using the keyword breastfeeding, self-efficacy, and breastfeeding confidence, an extensive search of the PubMed, Scopus, and ProQuest databases was performed. A total of 1,200 publications were found, from which, after excluding duplication and non-related papers, only 34 publications were considered relevant to the subject and examined in-depth. This study utilized the data extraction form developed by the Joanna Briggs Institute. Results: There were various predictors of breastfeeding self-efficacy, such as fetal attachment, social support, and positive prenatal experience. Studies have claimed that educational programs through educational sessions, information packages, and peer education have a positive effect on breastfeeding self-efficacy and the duration of exclusive breastfeeding. Conclusion: To facilitate successful breastfeeding, health care institutions could promote interventions regarding positive breastfeeding experiences. The data suggest that breastfeeding self-efficacy moves beyond our current understanding of motherhood. However, this evidence is limited to the study conducted in western and developed countries, and results are coming from studies with limited sample size. To provide an assessment and information on Asian mothers in developing countries, data are needed to describe their experiences and to examine factors associated with breastfeeding self-efficacy in this population