The Impact of the COVID-19 Pandemic on Stress and Other Psychological Factors in Pregnant Women Giving Birth During the First Wave of the Pandemic

BackgroundThe onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. MethodsPatients who gave birth during the first wave of the Corona pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 month postpartum).ResultsIn total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. ConclusionObstetrical patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic.Clinical trial registration: DRKS00022506

Initial Evidence for Symptoms of Postpartum Parent-Infant Relationship Obsessive Compulsive Disorder (PI-ROCD) and Associated Risk for Perturbed Maternal Behavior and Infant Social Disengagement From Mother

Infant socioemotional development and underlying brain maturation occur primarily within the context of early caregiver-infant relationships. Perinatal research demonstrates detrimental impact of postpartum pathology, including postnatal onset of maternal OCD—on the mother-infant relationship. The present study is the first to examine postnatal onset of a particular dimension of OCD symptoms focusing on close interpersonal relationships (relationship-OCD, i.e., ROCD) within a general population sample. Specifically, we assessed whether symptoms of Parent-Child ROCD (PC-ROCD), may onset postnatally, thus yielding symptoms of Parent-Infant ROCD (PI-ROCD). We adapted the previously validated Parent-Child ROCD measure for use during infancy to assess symptoms of PI-ROCD. The adapted measure, Parent-Infant Relationship Obsessive Compulsive Symptoms Inventory (PI-PROCSI), was administered to 143 mothers from the general population at 4-months postpartum. We investigated concurrent associations between postnatal onset of PI-ROCD, maternal depression and bonding, as well as longitudinal predictive associations with observed maternal and infant behaviors in dyadic interactions at 10 months. Due to dropout across the 1st year postpartum, the subsample with longitudinal data was substantially reduced compared to the full sample. PI-PROCSI scores explained unique variance in concurrent maternal depression over and above concurrent anxiety. PI-PROCSI scores also associated with concurrent impairments of maternal bonding. Moreover, unique associations emerged between maternal PI-ROCD scores and perturbations in both maternal and infant observable behaviors at 10-months. Specifically, observable perturbations in maternal behaviors mediated associations between symptoms of PI-ROCD at 4-months and observable infant avoidance of social engagement behaviors at 10-months. Findings suggest that parent-child ROCD symptoms may onset during the postnatal period, and that such symptoms may play a significant role in shaping quality of reciprocal caregiver-infant interactions. Theoretical and clinical implications are discussed.

Maternal Bonding in Early Infancy Predicts Childrens' Social Competences in Preschool Age

Background: There are many studies on mother-child-bonding with little theoretical doubt that better bonding may have a positive effect on further social development. However, there is hardly any empirical evidence. In particular, there is a lack prospective longitudinal studies.Methods: As part of a longitudinal study, bonding was assessed in a community sample of 97 healthy mothers using the Postpartum Bonding Questionnaire (PBQ) 6 weeks after birth of their child. Social competencies in the offspring were assessed using the Self- and Other-oriented Social Competencies (SOCOMP) at 5.5 years of age. A potential correlation between bonding and social competencies was tested using Spearman Rank Correlation.Results: Retention rate over 5.5 years was 77.23%. Lower Maternal Bonding Impairment Scores 6 weeks postnatally were positively related to childrens' social competences at 5.5 years of age.Conclusion: The present data confirm a positive and long-term influence of bonding on social skills and provide further evidence of the importance of parent child bonding for child development in general. This result should give reason to further investigate this relationship in depth, causally and at later points in time.

Influence of Nutrition and Maternal Bonding on Postnatal Lung Development in the Newborn Pig

BackgroundMicrobial colonization and immune cell maturation coincide at mucosal sites and are decisive for postnatal lung development. How external factors influence neonatal pulmonary immune development is poorly understood.ObjectiveTo elucidate the impact of key determinants in early life, nutrition, and maternal bonding, on postnatal lung maturation in a human-relevant animal model. To investigate the underlying immunological changes of impaired lung maturation and study the mechanisms of conversion.MethodsNewborn piglets were kept with or without isolation from their mothers and fed bovine milk-based infant formula or received milk of sow. Lung growth, histomorphology, respiratory immune responses, and lung microbiota were analyzed. Mother- and sow-milk-deprived piglets received maternal material or were reintroduced to the maternal environment at varying intervals to study options for reversal.ResultsFormula feeding combined with isolation of newborn piglets resulted in disturbed postnatal lung maturation. Reduced lung growth correlated with dampened IL-33 expression, impaired lung myeloid cell activation, and decreased Th1 differentiation, along with diminished richness and diversity of the lung microbiota. Transfer of bacteria-enriched maternal material reversed the negative effects on pulmonary immune maturation. Early (within 3 days) but not late (within 7 days) reintroduction to the mother allowed restoration of normal lung development.ConclusionOur findings reveal that lung growth, respiratory immunity, and microbial lung colonization in newborns depend on postnatal diet and maternal contact, and targeting these key regulators could promote lung development during this critical life stage.SummaryDisturbances in natural diet and reduced maternal contact during the neonatal period impair postnatal lung maturation. In pediatrics, timely breast milk feeding and intensive maternal bonding represent valuable intervention measures to promote early postnatal lung development.

Perinatal mental health outcome measures in a mother and baby unit

AimsTo Audit Perinatal outcome measures and understand better the population served in order to improve care and understand risks. Our audit standards inculded: paired HoNOS and PBQ recorded on admission and discharge as well as ASQ scores prior to admission.MethodHealth of the Nation Outcome Scales (HoNOS), Postpartum Bonding Questionnaire (PBQ) and Ages and Stages Questionnaires (ASQ) were recorded on Lorenzo and SystmOne. Scores were collected over 20 months within the same MBU and these were analyzed.ResultOur audit standards had an overall audit compliancy of 73% with paired HoNOS better than PBQ. Mental health severity mitigated and maternal bonding improved to a significant degree. Depression was the principal presentation as were patients from deprived areas. Only 55% of babies had ASQ scores completed appropriately pre- admission.ConclusionAs the newest MBU in the country, this an initial foray of perinatal outcomes. Gratifyingly, benefits of MBU admission for mother and baby is evidenced in this snapshot.

Effect of oxytocin and cortisol levels on mother–infant bonding

Oxytocin (OT) has been associated with mother–infant bonding, while cortisol levels have been associated with stressful response. The objective of this study was to explore the possible correlation between OT and cortisol levels and mother–infant quality of bonding. OT and cortisol levels were measured using urine and saliva tests. Maternal bonding was measured by observation and a post-partum bonding questionnaire. Our results, using a group of 29 mother–infant healthy dyads, found no correlation between OT and the nurturing condition, but we found positive correlations between OT and the expressed feelings of mothers towards their infants, as well as a negative correlation between cortisol and less intense bonding feelings (feel afraid or resents infant). Understanding the association between mother and infant bonding interactions and induced hormones should be a valuable tool for paediatricians and psychologist in promoting behaviours that will benefit future adult behaviour and society at large. Keywords: Oxytocin, cortisol, mother, infant bonding, effect.