Paternal psychological stress after detection of fetal anomaly during pregnancy. A prospective longitudinal observational study

Background and Aims. Knowledge of carrying a fetus with a prenatal diagnosed anomaly may cause acute psychological stress to the parents. Most studies focus on maternal stress, yet fathers are often present at the ultrasound examinations and birth, and therefore may be affected similarly to the expectant mother. However, to date no existing studies have examined how detection of a fetal anomaly emotionally affects the expectant fathers throughout the pregnancy. Our aim was to longitudinally examine general health perceptions, social dysfunction and psychological distress in a subgroup of men where fetal anomaly was detected during pregnancy. Methods and Results. This study is part of the SOFUS study, a prospective, longitudinal, observational study. Participants were recruited when referred for an ultrasound examination conducted by a specialist in fetal medicine at Oslo University Hospital on suspicion of fetal malformation (study group). We examined differences between the men in the study group (N= 32) and a comparison group (N=83) on the General Health Questionnaire (GHQ), Impact of Event Scale (IES) and Edinburgh Postnatal Depression Scale (EDPS) across four time points in pregnancy. Results from repeated measured ANOVA suggests that depression decreased over time among men in both groups (η2 =.15, p<.001). This effect was stronger in the study group, and differed from the comparison group (η2=.08, p<.001). There was also a main effect of time on IES scores, which decreased over time for both men in the study group and in the comparison group (η2=0.32, p<.001). That is, men in the study group were higher on IES initially, but this effect decreased more in the study group than in the comparison group. Men in tthe study group and comparison group did not differ on perceived general health (GHQ: p=.864,). Conclusion: Results suggests that detection of a fetal anomaly has implications for paternal mental health during pregnancy. Expectant fathers scored higher on EPDS and IES than the comparison group in the acute phase after detection of fetal anomaly, thus there is impetus to provide psychological support for fathers, as well as mothers, at this difficult time

The impact of diagnosed fetal anomaly, diagnostic severity and prognostic ambiguity on parental depression and traumatic stress: a prospective longitudinal cohort study

Introduction - The detection of a fetal anomaly during routine obstetric ultrasound is a potentially traumatic experience. The aim of this study is to examine longitudinally the impact of diagnosis of fetal anomaly on symptoms of depression and traumatic stress among mothers and fathers, and to examine how variations in psychological adjustment relate to diagnostic severity and prognostic ambiguity. Material and methods - In this prospective observational study conducted at a tertiary perinatal referral center, 81 mothers and 69 fathers with ultrasound findings of fetal anomaly completed the Edinburgh Postnatal Depression Scale (EPDS) and Impact of Events Scale (IES) at four time points in pregnancy (T1–T4) and 6 weeks after birth (T5). We compared this with depression and traumatic stress in a sample of non-affected parents (n = 110 mothers, 98 fathers). Results - Linear mixed effects models indicated that parents who received a diagnosis of fetal anomaly experienced higher levels of depression and traumatic stress over time, compared with non-affected parents. Depression: mean difference mothers = 4.46 ± 0.47, fathers = 2.80 ± 0.42. Traumatic stress: mean difference mothers = 20.04 ± 2.13, fathers = 12.66 ± 1.74. Parents with a more severe diagnosis experienced elevated symptoms compared with parents with a less severe diagnosis. Among mothers, prognostic ambiguity and changes in the anticipated diagnosis after birth were also associated with increased distress, regardless of whether the change was for the better or worse. Conclusions - Diagnosis of fetal anomaly increases risk of depression and traumatic stress in expectant mothers and fathers, both acutely and over time

Maternal caffeine consumption during pregnancy and offspring cord blood DNA methylation:an epigenome-wide association study meta-analysis

Background: Prenatal caffeine exposure may influence offspring health via DNA methylation, but no large studies have tested this. Materials &amp; methods: Epigenome-wide association studies and differentially methylated regions in cord blood (450k or EPIC Illumina arrays) were meta-analyzed across six European cohorts (n = 3725). Differential methylation related to self-reported caffeine intake (mg/day) from coffee, tea and cola was compared with assess whether caffeine is driving effects. Results: One CpG site (cg19370043, PRRX1) was associated with caffeine and another (cg14591243, STAG1) with cola intake. A total of 12-22 differentially methylated regions were detected with limited overlap across caffeinated beverages. Conclusion: We found little evidence to support an intrauterine effect of caffeine on offspring DNA methylation. Statistical power limitations may have impacted our findings. </p

The Role of Pre- and Postnatal Timing of Family Risk Factors on Child Behavior at 36 months

Children growing up in disharmonious families with anxious/depressed mothers are at risk for emotional and behavioral difficulties, however whether these associations reflect postnatal environment, prenatal exposure, or an overall liability is still unclear. This study used prospectively collected data from 24,259 participants of the Norwegian Mother and Child Cohort Study (MoBa). Mothers reported on anxiety/depression and family disharmony twice in pregnancy and twice post pregnancy, as well as on their child’s physical aggression and crying behavior at age 36 months. First, results from an autoregressive cross-lagged model showed a substantial stability in both maternal anxiety/depression and family disharmony from pregnancy to 18 months postnatal, but there was no indication that family disharmony led to maternal anxiety/depression, or the other way around. Second, structural equation models further suggests that the main risk derived from an overall liability, that is, a lasting effect of family risks that spanned the two time periods

Developmental patterns in coping and later mental health : a longitudinal study from age 15 to 18 and 24 years of age

Background: The transition from adolescence to adulthood is a period with major and minor stressors while coping strategies have not yet been fully established. The current study will attempt to clarify the nature of the relationships between coping strategies in early adolescence and young adulthood using a longitudinal framework. Method: This study of 95 young adults is the fifth follow up of a cohort study starting in 1985 when these adults were 4 years of age. Based on a longitudinal design, data was collected by using self-administered questionnaires sent out at 15, 18 and now aged 24 years. The sample size for participating in all 3 age points was n=56. Age and gender differences in coping across 3 age points were analysed. Further the long-term effect of active or avoidant coping on psychological distress was assessed by hierarchical regression analyses. Results: Active coping strategies were continuously more frequently used among young people than avoidant coping strategies. The results did not find evidence for stable patterns in neither active nor avoidant coping over a nine-year period. It turned out that there was a shift in stability of coping patterns at age 18. Psychological distress among the 24 year olds was predicted by concurrent avoidant strategies. None of the coping patterns experienced at 15 and 18 years were significantly associated with psychopathology at 24 year

Twins and other multiples

Being a multiple birth child is a unique social circumstance that places siblings together from the time of their conception. During their early years, multiple birth siblings spend considerably more of their time together than close‐spaced single‐born children, a situation that presents opportunities for learning and companionship but also greater potential for comparison, competition, and conflict. A key focus for research has been questioning the developmental effects of growing up in these unique circumstances: Does being a multiple birth child present risks for development? Are there developmental strengths associated with being a multiple birth child? What are the variations in the multiple birth children's relationship and how might these affect relationships with others? What are the implications of being a multiple birth child for social experiences beyond the family? Does being a multiple birth child affect social inclusion and quality of peer relationships? This entry addresses these key questions