CROATIAN PERINATOLOGY Past, today and future

SAŽETAK. Prikazana je prošlost, sadašnje stanje i gledanje na budućnost hrvatske perinatologije. Pod prošlošću su spomenuti zabilježeni podatci o primaljstvu, zatim od početka 20. stoljeća specijalizacija iz ginekologije i opstetricije. Suvremena perinatologija, kao zbir znanstvene i stručne djelatnosti materno-fetalne medicine i neonatologije, potpomognutih drugim strukama medicine, započinje šezdesetih godina 20. stoljeća, formalno 1968. prvim Njemačkim kongresom, te 1969. godine u Berlinu prvim Europskim kongresom perinatalne medicine, od kada su začetci Europske udruge perinatalne medicine. U Hrvatskoj je Sekcija za perinatalnu medicinu Hrvatskoga liječničkog zbora utemeljena 1972. godine (od 1992. godine Društvo). Znanstvena i stručna djelatnost započeta je i poticana u Centru (kasnije Zavodu) za perinatalnu medicinu Klinike za ženske bolesti i porode KBC-a u Zagrebu, što je ubrzo prošireno na ostale klinike u zemlji te veća rodilišta. Perinatološka djelatnost se očitovala u brojnim domaćim (Perinatalni dani, Savjetovanja o perinatalnom mortalitetu) i međunarodnim u nas organiziranim skupovima (Alpe-Adria meetings, Organization Gestosis meetings, Ian Donald Inter-University School of Medical Ultrasound, Erich Saling School of Perinatal Medicine, European School of Perinatal Medicine & Recent Advances in Perinatal Medicine). Spomenuti su postdiplomski studiji: Perinatologija i neonatologija, Ultrazvuk u kliničkoj medicini, Zaštita majke i djeteta; tečajevi usavršavanja: iz ginekologije i perinatologije, iz neonatologije, iz ultrazvučne dijagnostike. Prikazan je osnutak i razvojni put časopisa »Gynaecologia et Perinatologia«. Glede budućnosti date su neposredno potrebne mjere te sugerirane mogućnosti razvojne biologije u dijagnostici i liječenju patoloških stanja trudnoće, koje bi mogle biti prevencija kasnijih bolesti u čovjeka

The Relationship Between Infant Crying and Father Well-Being

Infant excessive crying and fussing has been linked to adverse maternal outcomes such as increased depression and stress, and decreased feelings of parenting self-efficacy. Infant crying has also been identified as the number one trigger caregivers report prior to an abusive action, placing infants who cry excessively at risk. Fathers and male caregivers have been identified as the primary offenders in the majority of infant abuse cases, suggesting a particular risk between fathers and infants who cry excessively. However, the relationship between excessive crying and fathers has not been explored to the same extent as mothers. In an effort to address the identified risks of infant crying and fathers, the aim of this study was to investigate how fathers\u27 well-being is impacted by infant crying and fussing. Fathers\u27 experience of crying and how they cope when caring for an inconsolable infant was also explored. One hundred and ninety-two fathers of infants under one year of age completed online measures of depression (EPDS), parenting stress (PSI/SF), parenting self-efficacy (MSE), and coping (RWCC). Fathers reported amount of infant crying (categorized adhering to Wessel\u27s Rule of Three for colic criteria) as well as concern about their infant\u27s crying and fussing. Ten fathers participated in a semi-structured phone interview about the experience of and coping with infant crying and parenting in general. Sixteen percent of fathers met criteria for depression based on a cut-off score of 10 or greater on the EPDS. Based on Wessel\u27s criteria, 20% of infants were categorized as having colic. Thirty percent of fathers indicated that they were finding their infant\u27s crying and fussing to be a problem or upsetting. Of these fathers, approximately 50% did not meet criteria for colic, suggesting over half of these fathers have a problem with the crying, but did not report \u27excessive\u27 amounts of crying. Results indicated significant relationships between infant crying and father depression, parenting stress and parenting self-efficacy. Perception of a crying was a significant predictor of parenting stress, depression and parenting self-efficacy, and colic was only a significant predictor for parenting stress. Taken together, these results suggest that fathers\u27 perception of infant crying has a greater impact and is a stronger predictor of father well-being than the amount of crying reported (i.e., colic criteria). In addition, fathers who met criteria for depression, reported a crying problem, and their infant met colic criteria had the highest parenting stress and depressions scores and the lowest parenting self-efficacy scores compared to all fathers in the study. Fathers most often described problematic crying in terms related to how the crying behavior personally impacts them, or using descriptions including feelings of helplessness. Coping explored in semi-structured interviews revealed a theme of \u27cognitive reappraisal\u27. Fathers confronted with inconsolable crying described feelings of \u27losing control\u27 and a process of cognitively reappraising the situation and the infant\u27s behavior as a method of coping. Interview results also revealed a heavy reliance on fathers\u27 co-parent as a source of support. Interview fathers had little to offer in regards to suggested support services for fathers. The findings of this study offer evidence towards the importance of incorporating parent perception into research on infant crying. Study results also indicate that fathers report on their infants\u27 crying similar to mothers, suggesting that fathers can and should be included in research on infant crying as primary reports. Findings also suggest that providers working with families and infants pay particular attention to the well-being of fathers and incorporate more systematic screening and involvement related to father perception of their infant behavior, especially if a crying problem is reported. Finally, the results of this study offers theoretical explanations of the risk associated with infant crying and fathers