Maternal Efficacy about Pregnancy and Birth Mediates the Relationship between Perinatal Complications and Maternal Depression

• In Event: Poster Session 05
  In Poster Session: PS 05 Topic - Family Context & Processes

Abstract

It has been well-established that maternal depression negatively impacts infants’ physical health, sleep, and development across multiple domains (Slomian et al., 2019). Much research has been conducted to examine predictors of maternal depression, including postpartum depression (PPD) specifically, such as socio-demographic characteristics, adverse life events, intimate relationships, and social supports (Norhayati et al., 2015). Few studies, however, have examined the role of pregnancy and birth experiences such as perinatal complications (Ghaedrahmati et al., 2017) and delivery preferences (Houston et. al, 2015). Preliminary work highlights that maternal perceptions of birth experiences may be related to subsequent PPD, but further research is necessary. The current study examines multiple possible influences at the individual and family level known to influence PPD (Norhayati et al., 2015). It was hypothesized that greater perinatal complications, lower maternal education, younger maternal age, non-partnered marital status, more stressful life events, and poorer maternal efficacy about pregnancy and birth experiences would be associated with postpartum maternal depression. It was also hypothesized that maternal efficacy about pregnancy and birth would mediate the relationship between perinatal complications and later maternal depression.

Participants in the present study (N = 515) are part of an ongoing longitudinal multi-site investigation examining the psychometric properties of a new web-based caregiver report instrument to monitor and track infant and toddler development. Participating dyads include racially and socio-economically diverse pre- and full-term infants who were enrolled at birth and are being followed for 18 months. Maternal education, age, marital status, perinatal complications, and stressful life events were collected within 30 days of birth. Maternal efficacy about pregnancy and birth was assessed at 2-months infant age (n = 396) using the Maternal Self Report Inventory-Short Form, Feelings During Pregnancy and Delivery Scale (MSRI-SF; Shea & Tronick, 1988). Maternal depression symptoms were measured at 4-months infant age (n = 360) using the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987). Infant age was adjusted for premature infants.

Bivariate analyses demonstrated significant correlations among some demographic, perinatal, and depression variables (See Table 1). However, the only significant predictor of the outcome of interest, maternal depression, was maternal efficacy about pregnancy and birth. A mediation analysis using PROCESS (Hayes, 2017) revealed a significant indirect effect of perinatal complications on maternal depression symptoms at 4-months infant age through maternal efficacy about pregnancy and delivery experiences at 2-months infant age (See Figure 1).

These results suggest that perinatal complications may not directly predict postpartum symptoms of depression, but rather, perinatal complications may impact the extent to which a mother perceives her efficacy during pregnancy and birth, which in turn may impact subsequent mental health symptoms. These findings highlight the need for additional therapeutic support for birthing mothers to reconcile negative perinatal experiences and perceived efficacy during this transformative life experience. Interventions such as these may improve maternal adjustment during the postpartum period, and therefore, positively impact the mother-infant relationship and early child development.

Authors

• Shannon Franz, University of Michigan - Ann Arbor
  Presenting Author

• Kirsten Oard, University of Michigan - Ann Arbor
  Non-Presenting Author

• Lesa Dieter, Case Western Reserve University School of Medicine
  Non-Presenting Author

• Katherine L Rosenblum, University of Michigan - Ann Arbor
  Non-Presenting Author

• Alissa Christine Huth-Bocks, Wayne State University
  Non-Presenting Author