Reciprocal relationships between time pressure and mental or physical health in Australian mothers of preschool aged children

The associations between time pressure and health are typically conceptualised and examined as unidirectional. This study examined the reciprocal relationships between time pressure and mental and physical health amongst working mothers of preschool children; a high-risk group for feeling time pressured. Using 5 waves of a panel study of Australian mothers when their children were aged 0–4 (n = 3878) and cross-lagged structural equation models, we find strong significant negative reciprocal associations between time pressure and mental and physical health, although these reciprocal associations were stronger and more consistent over time for mental health. Our results indicate that physical health takes a couple of years to deteriorate to a point where the reciprocal effects with time pressure become apparent, but for mental health the reciprocal effects are immediate, present at all time points and consistently strong. Findings suggest there are significant reciprocal health consequences of the time pressure experienced by working mothers and government policy encouraging mothers back into the workforce without adequate supports may be harmful for health

The role of micro-organisms (Staphylococcus aureus and Candida albicans) in the pathogenesis of breast pain and infection in lactating women: study protocol

Background: The CASTLE (Candida and Staphylococcus Transmission: Longitudinal Evaluation) study will investigate the micro-organisms involved in the development of mastitis and &ldquo;breast thrush&rdquo; among breastfeeding women. To date, the organism(s) associated with the development of breast thrush have not been identified. The CASTLE study will also investigate the impact of physical health problems and breastfeeding problems on maternal psychological health in the early postpartum period.Methods/Design: The CASTLE study is a longitudinal descriptive study designed to investigate the role of Staphylococcus spp (species) and Candida spp in breast pain and infection among lactating women, and to describe the transmission dynamics of S. aureus and Candida spp between mother and infant. The relationship between breastfeeding and postpartum health problems as well as maternal psychological well-being is also being investigated. A prospective cohort of four hundred nulliparous women who are at least thirty six weeks gestation pregnant are being recruited from two hospitals in Melbourne, Australia (November 2009 to June 2011). At recruitment, nasal, nipple (both breasts) and vaginal swabs are taken and participants complete a questionnaire asking about previous known staphylococcal and candidal infections. Following the birth, participants are followed-up six times: in hospital and then at home weekly until four weeks postpartum. Participants complete a questionnaire at each time points to collect information about breastfeeding problems and postpartum health problems. Nasal and nipple swabs and breast milk samples are collected from the mother. Oral and nasal swabs are collected from the baby. A telephone interview is conducted at eight weeks postpartum to collect information about postpartum health problems and breastfeeding problems, such as mastitis and nipple and breast pain.Discussion: This study is the first longitudinal study of the role of both staphylococcal and candidal colonisation in breast infections and will help to resolve the current controversy about which is the primary organism in the condition known as breast thrush. This study will also document transmission dynamics of S. aureus and Candida spp between mother and infant. In addition, CASTLE will investigate the impact of common maternal physical health symptoms and the effect of breastfeeding problems on maternal psychological well-being.<br /

Women's employment in pregnancy and following birth: effect on psychological well-being

© 2010 Dr. Amanda Ruth CooklinCurrently in Australia, 80% of women are employed during first pregnancy, and 40% resume employment in the postpartum. The first aim of this study was to identify which of a broad range of factors, including maternal preferences, maternal separation anxiety and maternity entitlements, contributed to maternal employment in the first 10 postpartum. The second aim was to identify the contribution of women’s satisfaction with employment arrangements to their psychological well-being. Participants were 165 employed pregnant women over 18 years of age and with sufficient English for completion of study materials, systematically recruited in the third trimester of pregnancy. Data were collected in pregnancy and at 3 and 10 months postpartum. Maternal preferences, not or no longer breastfeeding and lower maternal separation anxiety were associated with significantly increased likelihood of resuming postpartum employment when maternal age, educational attainment and occupational status were controlled for. A constellation of adverse employment conditions made independent contributions to measurably worse maternal mood including experiencing sexual discrimination in pregnancy, no maternity entitlements when known determinants of poorer maternal well-being were controlled in regression analyses. These findings provide evidence about the relevance of structural determinants to maternal well-being, and highlight the urgency of a national paid parental leave scheme in Australia

Comorbid anxiety and depression: a community-based study examining symptomology and correlates during the postpartum period

Background: Despite indications that anxiety and depression co-occur frequently within the postpartum period, studies identifying the correlates associated with this comorbidity are rare. Objective: This study assessed variation in social and maternal circumstances, based on comorbid anxiety and depression symptomology. Methods: A large community-based sample of 1070 Australian postpartum women completed the Living with a Young Baby online survey. Mothers were categorised into groups: (a) comorbid anxiety and depression symptomology, (b) anxiety only, (c) depression only, or (d) neither depression nor anxiety. Multinomial Logistic Regression (MLR) investigated variation in correlates between the groups. Results: Comorbid anxiety and depression symptomology was common (13.4%), and was associated with greater symptom severity. Women in the ‘comorbid’ group more often experienced financial hardship, cessation of breastfeeding, infants with difficult temperaments, inadequate social support or help, and stressful adverse life events in comparison to mothers in the ‘neither symptomology’ group. They were also more likely to have infants with difficult temperaments compared to the depression only group, and to receive inadequate help and support compared to the anxiety only group. Conclusions: Comorbid anxiety and depression symptomology is common postpartum and is associated with considerable adversity across a wide range of demographic, economic and social correlates. Abbreviations: EPDS: Edinburgh Postnatal Depression Scale; STAI: State-Trait Anxiety Inventory; MLR: Multiple Logistic Regression; LYBS: Living with a Young Baby Survey; LSAC: Longitudinal Study of Australian Children; STSI: Short Temperament Scale for Infants; ANOVA: Analysis of Variance; M: Mean; SD: Standard Deviation; CI: Confidence Interval; OR: Odds RatioLL was funded by an Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship #1035803. AC is supported by the Roberta Holmes Transition to Contemporary Parenthood Program, Judith Lumley Centre, La Trobe University. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review

Background Men's experiences of anxiety within the perinatal period can adversely impact themselves, their partner and infant. However, we know little about the prevalence and course of men's anxiety across the perinatal period. The current review is one of the first to systematically review the published literature. Methods Five databases (PubMed, PsycINFO, Cochrane, SCOPUS, and Web of Science) were searched to identify relevant papers published prior to April 2015. The literature search identified articles with data for expectant fathers (prenatal period) and/or fathers of an infant aged between 0 and 1 (postnatal period). The following data were extracted: (a) anxiety disorder prevalence (diagnostic clinical interviews), (b) 'high' anxiety symptom prevalence (above thresholds/cut-points on anxiety symptom scales) and (c) mean anxiety levels (anxiety symptom scales). Initially, 537 unique papers were identified. Subsequently, 43 papers met criteria for inclusion in the review. Results Prevalence rates for 'any' anxiety disorder (as defined by either diagnostic clinical interviews or above cut-points on symptom scales) ranged between 4.1% and 16.0% during the prenatal period and 2.4-18.0% during the postnatal period. The data reviewed suggest the course of anxiety across the perinatal period is fairly stable with potential decreases postpartum. Limitations Wide variation in study measurement and methodology makes synthesis of individual findings difficult. Anxiety is highly comorbid with depression, and thus measures of mixed anxiety/depression might better capture the overall burden of mental illness. Conclusions Anxiety disorders are common for men during the perinatal period. Both partners should be included in discussions and interventions focused on obstetric care and parent mental health during the perinatal period

Which mothers wean their babies prematurely from full breastfeeding? An Australian cohort study

Aim: To identify the maternal and infant characteristics associated with an early transition from full breastfeeding to complementary or no breastfeeding during the first 2 months of life in a large, representative cohort of Australian infants. Method: Multinomial logistic modelling was performed on data for infants with complete breastfeeding and sociodemographic data (N = 4679) including maternal age, education, smoking, employment, pregnancy and birth outcomes. Results: Ninety-one percent of women initiated breastfeeding. Sixty-nine percent of infants were being fully breastfed at 1 month, and 59% were fully breastfed at 2 months. Maternal characteristics - age less than 25 years, smoking in pregnancy, early full-time postnatal employment and less educational attainment - were associated with early breastfeeding cessation. Infant factors - multiple birth, caesarean birth, infant or first birth - were associated with a transition to complementary breastfeeding in the first postnatal month. Conclusion: Breastfeeding duration is substantially affected by breastfeeding outcomes in the first postpartum month. The first month is an important window for evidence-based interventions to improve rates of full breastfeeding in groups of women identified as at risk of early breastfeeding cessation

Wide Awake Parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue

Abstract Background Exhaustion and fatigue are commonly experienced by parents during the post-partum period, and can have implications for daily functioning, mental health and parenting practices. There is a need for the development of effective interventions to assist parents with the management of fatigue. This paper outlines the procedure for a randomised controlled study which aims to test the efficacy of Wide Awake Parenting, a program for the management of fatigue in the postnatal period. Methods/design Parents with an infant less than 6 months of age, and from seven Local Government Areas in Melbourne, Australia were invited to participate in this study. Parents were randomised to receive the Wide Awake Parenting program (intervention groups) or usual care (control group) offered by health services. The Wide Awake Parenting program provides parents with psycho-education and information about fatigue, and strategies to reduce its effects either via a self-directed method, or professionally led with a home visit and telephone support. Baseline data will be collected prior to randomisation, and further data will be collected at 2- and 6-weeks post intervention. Discussion To our knowledge this is the first randomised controlled trial of a program which compares the efficacy of a self-management approach and health professional assistance for the management of fatigue in the early post-partum period. If effective, it could offer an important, universal public health management approach to this common health concern. Trial registration number Australian New Zealand Clinical Trials Registry, ACTRN12611000133932.</p

Employment conditions and maternal postpartum mental health: Results from the Longitudinal Study of Australian Children

Maternal postpartum mental health is influenced by a broad range of risk and protective factors including social circumstances. Forty percent of Australian women resume employment in the first year postpartum, yet poor quality employment (without security, control, flexibility or leave) has not been investigated as a potential social determinant of maternal psychological distress. This paper examines whether poor quality jobs are associated with an increased risk of maternal postpartum psychological distress. Data were collected from employed mothers of infants =12 months (n=1,300) participating in the Longitudinal Study of Australian Children. Logistic regression analyses estimated the association between job quality and maternal psychological distress, adjusting for prior depression, social support, quality of partner relationship, adverse life events and sociodemographic characteristics. Only 21% of women reported access to all four optimal job conditions. After adjustment for known risk factors for poor maternal mood, mothers were significantly more likely to report psychological distress (adjusted OR=1.39, 95% CI 1.09, 1.77) with each reduction in the number of optimal employment conditions. Interventions for maternal postpartum affective disorders are unlikely to be successful if major risk factors are not addressed. These results provide strong evidence that employment conditions are associated with maternal postpartum mood, and warrant consideration in psychosocial risk assessments and interventions