Maternal Psychological State and Infant’s Temperament at Three Months

Introduction

The hypothesis of this study is “maternal perinatal states of depression or anxiety are associated with increased difficulty in the temperament of the baby as perceived by mothers” (Vedova, 2014, p. 520). The available literature shows that the development of children born by mothers suffering from mood or anxiety disorders during the perinatal stage is likely to be affected negatively (Bassi et al., 2017; Bennett, Schott, Krutikova,& Behrman, 2015; McAndrew, 2017).

For instance, studies have shown that fetal exposure to maternal anxiety or depression leads to increased cases of sleep disturbances and inconsolable crying in newborns (Vedova, 2014). Similarly, research has proved a positive correlation between antenatal maternal states of mind and increased risk of depression and other mental problems in adults.

However, despite the numerous studies showing that antenatal maternal states of mind could potentially affect the neurocognitive development and other aspects of newborns, there is limited research on the temperament of young infants. Therefore, the author sought to fill this gap in knowledge by studying the effects of perinatal maternal states on the temperament of newborns aged 3 months. The author hoped that by establishing the correlation between the mothers’ mental state and the newborns’ temperament, recommendations could be made to include intervention measures early in pregnancy to prevent the occurrence of such incidences.

Description of Procedures

Research Design

A longitudinal study design was used. Four healthcare service providers, which were part of the National Health System (NHS), in northern Italy, were selected for the study. The providers included two hospitals and two antenatal clinics. The participating women were required to complete self-report measures during their last trimester of pregnancy (T1) and at 3 months after giving birth (T2). To address ethical issues associated with this nature of the study, the author obtained approval from the relevant Ethics Committees.

Participants

The participants were recruited from a group of women attending classes on childbirth in the selected antenatal clinics. Other participants were selected during their ultrasound sessions in the two selected hospitals. However, the author could not recruit all the women, and thus an inclusion/exclusion criterion was used. For a participant to be selected for the study, she had to meet the following requirements – “Italian nationality, aged between 18 and 40 years, partnered, nulliparous, low-risk pregnancy, gestational age between 28 and 36 weeks, attending prenatal classes and without relevant obstetric and clinical pathologies” (Vedova, 2014, p. 522).

Ultimately, 146 women were selected to participate in the study. However, by T2, 23.3 percent or 34 participants were not available to continue with the study. Additionally, 5 more were excluded due to missing data or having preterm deliveries. Therefore, the final sample that was considered during the analysis of the results had 107 participants.

Measures

Questionnaires were used to collect data derived from assessing the participants during pregnancy (T1). The questions were dichotomous seeking to evaluate various attributes, such as psychological risk factors and pregnancy-related variables among other factors including general health and socio-demographics. The level of depression among the participants was measured using CES-D, while anxiety levels were assessed using STAI. Alexithymia was measured using TAS-20, while PBI was used to evaluate the parenting styles of the participants’ parents during the women’s childhood. To assess the participants’ perception of the personal level of social support, the author used MSPSS.

Additionally, PAI was used to assess the level of mothers’ emotional involvement with the newborns. At T2, assessments were carried out to evaluate the delivery and early postpartum experiences of the participating mothers. A questionnaire was used to collect this data. The other evaluation involved the assessment of the newborns’ temperament at 3 months after birth and EIQT was used for this purpose. In a bid to assess the newborns’ temperament, the following dimensions of the EIQT were measured – activity, rhythmicity, approach/withdrawal, adaptability, intensity, mood, persistence, distractibility, and sensory threshold (Vedova, 2014).

The independent variable was the mothers’ maternal psychological state during the last trimester of pregnancy (T1) and at 3 months after delivery (T2). On the other hand, the dependent variable was the newborns’ temperament at the age of 3 months. Descriptive statistics were used to calculate both qualitative and quantitative variables. The internal consistency of the questionnaires was evaluated using the Cronbach’s α coefficient.

In comparing maternal variables based on the newborns’ temperament, Chi-Square and Student’s t-tests were used for categorical and continuous or ordinal variables respectively. Ultimately, “Spearman’s correlation was calculated to evaluate the associations between mother’s and infant’s variables” (Vedova, 2014, p. 524). SPSS-17 was used in the analysis of the collected data.

The Results of the Research

Descriptive Analysis

Out of the 146 women selected initially to participate in the study, 73.3 percent of them (107 participants) were used for the final analysis. After analyzing psychosocial and demographic attributes, there were no significant differences between participants with complete data and those with incomplete data about their demographics. Additionally, there were no differences between participants selected at the hospitals while undergoing ultrasound sessions and those attending antenatal education at the selected clinics. Mean scores from the questionnaires showed that the majority of the participants experienced less depression at postpartum (T2) as compared to during the last trimester of pregnancy (T2).

However, perceived social support increased during this period. Correlational analysis established a positive correlation between maternal psychometric measures at T1 and T2 and the temperament measures of the newborns. In other words, the results showed that maternal perinatal depression and other mental conditions contributed significantly too difficult temperaments in their newborns at 3 months after birth. Therefore, the research hypothesis was proven.

Discussion of the Results

The study sought to establish whether maternal psychological state during the perinatal period of pregnancy and postpartum corresponded to that of 3-month-old newborns. The results showed a statistically significant association between several maternal psychological attributes and the infants’ temperament at 3 months after birth. However, at the univariate level, the established associations moved in different directions contrary to what was expected.

For instance, children born of married women were reported to have more intense reactions as compared to their counterparts born of unmarried women. On the other hand, children born out of planned pregnancy were described as less joyful as compared to those born out of unplanned pregnancies. Another difference involved children born through the caesarian section as they showed less agitation as compared to their counterparts born through normal vaginal delivery. These findings underscore new areas of research that emerged from this study.

However, the results associated with the research objective showed interesting findings. Participants, who had experienced stressful events within one year before the study, reported their children to be less regular or unpredictable. Similarly, more participants, who had previously gone through a miscarriage, noted that their children were withdrawn as compared to participants who had not experienced the same. On the other hand, women with good support from their spouses reported that their children could be easily distracted from fussing. Similarly, children born of mothers with a high education level were less agitated. Finally, newborns exclusively breastfed for the first three months after delivery were less intense.

These results show that a newborn’s different temperament features could be subject to perinatal occurrences. First, the results indicate that maternal psychological stress during this period could affect the child’s temperament negatively. Such elements could be classified as risk factors. On the other hand, factors such as exclusive breastfeeding and spouse support appear to affect a newborn’s temperament positively. Therefore, such elements could be classified as protective factors. In this case, risk factors include maternal prenatal and postnatal depression and stress. On the other hand, protective factors include the mother’s prenatal attachment and social support.

In summary, the results showed that an “increase in the prenatal and postnatal maternal measures of anxiety or depression was associated with elevated scores in the child’s temperament measure (rhythmicity, distractibility, mood, EITQ sum) indicating more difficulties in the child’s general behavior” (Vedova, 2014, p. 529). This conclusion confirms the study’s hypothesis. Therefore, care providers should come up with strategies on how to maximize the protective factors and minimize the risk factors during the perinatal stage to ensure that newborns’ temperaments are affected positively.

References

Bassi, M., Delle Fave, A., Cetin, I., Melchiorri, E., Pozzo, M., Vescovelli, F., & Ruini, C. (2017). Psychological well-being and depression from pregnancy to postpartum among primiparous and multiparous women. Journal of Reproductive and Infant Psychology, 35(2), 183-195.

Bennett, I. M., Schott, W., Krutikova, S., & Behrman, J. R. (2015). Maternal mental health, and child growth and development, in four low-income and middle-income countries. Journal of Epidemiology and Community Health, 70(2), 168-173.

McAndrew, A. J. (2017). Maternal perinatal depression: Emotional development in offspring from infancy to adolescence. Early Child Development and Care, 189(1), 168-177.

Vedova, D. (2014). Maternal psychological state and infant’s temperament at three months. Journal of Reproductive and Infant Psychology, 32(5), 520-534.