Depressive Symptoms in Fathers during the First Postpartum Year: The Influence of Severity of Preterm Birth, Parenting Stress and Partners' Depression

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants' birth weight categories, fathers' EPDS scores at 3 and 9 months, Parent-Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth

Prematurità e sintomatologia depressiva perinatale paterna: decorso e qualità delle interazioni diadiche nel primo anno di vita

La nascita pretermine rappresenta un fattore di rischio per la transizione alla genitorialità, con un aumentato tasso di insorgenza di psicopatologia perinatale. La letteratura si è a lungo focalizzata sulla sintomatologia delle madri di bambini prematuri, mentre solo recentemente la ricerca sta indagando gli effetti sugli stati affettivi paterni. Lo studio si propone di indagare il decorso della sintomatologia perinatale paterna durante i primi 12 mesi di vita, valutando l’impatto della severità della prematurità e del livello di stress genitoriale. È stato inoltre valutata la qualità delle interazioni precoci padre-bambino, considerando l’effetto della prematurità, della sintomatologia depressiva e dei livelli di stress paterni. Lo studio ha coinvolto 165 padri ed i loro bambini, di cui 80 nati a termine e 85 di prematuri, a loro volta suddivisi in 47 Very Low Birth Weight (VLBW: peso alla nascita 1000-1500 gr) e 38 Extremely Low Birth Weight (ELBW: peso alla nascita <1000 gr). A 3 e 12 mesi di età corretta del bambino, i padri hanno compilato l’Edinburgh Postnatal Depression Scale (EPDS) e il Parenting Stress Index-Short Form (PSI-SF). Inoltre, in un sottocampione di diadi (23 padre-bambino nato a termine, 23 padre-bambino prematuro), la qualità dell’interazione diadica è stata valutata tramite il Child-Adult Relationship Index (CARE Index). A 12 mesi, i padri ELBW hanno mostrato un significativo decremento dei punteggi medi PSI-SF totale rispetto a quelli ottenuti a 3 mesi. I punteggi EPDS paterni a 12 mesi risultavano significativamente predetti dalla severità della nascita pretermine e dai punteggi EPDS e PSI-SF a 3 mesi. Infine, la nascita ELBW prediceva significativamente migliori pattern interattivi sensibili (padri) e cooperanti (bambino) al CARE Index. I risultati dello studio evidenziano la rilevanza del monitoraggio longitudinale dell'esperienza affettiva della paternità in un contesto di potenziale vulnerabilità quale quello della nascita pretermine

Infant-Directed Speech to 3-Month-Old Severe Preterm Infants: The Influence of Birth Weight and Maternal Depressive Symptoms

Severe premature birth (<32 weeks) is a risk factor for the development of maternal perinatal depression, while also affecting dyadic interactions and child outcomes. Although several studies have examined the impacts of prematurity and depression on early interactions, only a few studies have investigated the features of maternal verbal input. Furthermore, no study has investigated the relationship between the effect of severity of prematurity according to birth weight and maternal input. This study aimed to explore the effects of the severity of preterm birth and postnatal depression on maternal input during early interactions. The study included 64 mother–infant dyads, classified into three groups: 17 extremely low birth weight (ELBW) preterm infants, 17 very low birth weight (VLBW) preterm infants, and 30 full-term (FT) infants. At 3 months postpartum (corrected age for preterm infants), the dyads participated in a 5-min free interaction session. Maternal input was analyzed using the CHILDES system in terms of lexical and syntactic complexity (i.e., word types, word tokens, mean length of the utterance) and functional features. Maternal postnatal depression (MPD) was assessed using the Edinburgh Postnatal Depression Scale. The results showed that in high-risk conditions (i.e., ELBW preterm birth and maternal postnatal depression), maternal input was characterized by a lower frequency of affect-salient speech and a higher proportion of information-salient speech, specifically as directives and questions, suggesting that mothers in these conditions may experience more difficulty in conveying affective content to their infants. Moreover, the more frequent use of questions may reflect an interactive style characterized by a higher level of intrusiveness. These findings provide preliminary evidence of the impacts of prematurity severity and maternal depression on maternal verbal input, highlighting the importance of assessing both factors in clinical practice. Understanding the mechanisms underlying the impacts of prematurity and depression on early interactions may inform the development of tailored interventions aimed at promoting positive parent–infant interactions and child development

Psychological adjustment of infertile couples in the postpartum period: the characteristics of parental mental representations and early parent-infant interactions

Clinical and empirical literature has recognized Assisted Reproductive Technology (ART) as a stressful condition that may impact on psychological transition to parenthood during pregnancy. However, poor attention has been paid to investigate parental adjustment in the postpartum period, a crucial moment for the parent-infant relationship. We therefore aimed to investigate transition to motherhood and fatherhood in the postnatal period, discussing an overview of recent studies on postnatal outcomes (parental representations and parent-infant interactions) of infertile couples after a successful ART treatment. The first study included a sample of 17 ART conceiving and 25 spontaneous conception (SC) couples; at 3 months postpartum all parents completed the Semantic Differential of IRMAG/IRPAG (Interview of Maternal/Paternal Representations During Pregnancy; Ammaniti et al., 1992, 1995, 2006), a self-report tool to evaluate domains of mental representations according to individual (Child, Self-as-womanman, and Partner) and parental (Self-as-parent, Own parent) characteristics. The second study aimed to assess the quality of a 5-minute free parent–infant interaction on 25 ART and 31 SC couples and their 3-month-old baby. Fathers, mothers and babies’ interactive patterns were coded using CARE-Index (Crittenden, 1994). Results on mental representations showed that both ART mothers and fathers had significantly higher positive representations of the Child than SC ones. The type of ART treatment (IVF/ICSI) showed a significant influence on the representation of Self-as-woman/man, with higher positive scores in IVF parents compared to ICSI ones. Regarding parent-infant interactions, both ART mothers and fathers showed more frequently “inept” and “at-risk” interactive patterns, compared to SC ones. ART variables significantly influenced interactive behaviours: infants conceived at first ART cycle showed lower scores at Difficulty scale than those conceived after more attempts; ICSI babies got lower scores at Compulsivity and higher at Passivity compared to IVF ones. These findings support the clinical relevance of exploring parents’ psychological adjustment after successful ART treatments, to improve the understanding of the transition to parenthood in infertile couples and to target more specific interventions when needed

Preterm infant negative affectivity: the relation with severity of prematurity, parental depression and dyadic adjustment

Introduction Preterm birth, especially if severe, could negatively influence parents’ perception of their baby. Indeed, parents often report a difficult temperament, with high level of negative affectivity (NA). When parental perception of infant NA was investigated, most studies focused on mothers, and possible influences of their affective states. Conversely, paternal perceptions are less considered as far as the role of fathers’ or family variables. Aim To explore the parental perceptions of preterm infant NA in a family perspective, considering the possible contributing factor of birth weight (Extremely Low Birth Weight infants-ELBW, &lt; 1000 gr.; Very Low Birth Weight-VLBW, 1000-1500 gr.), parental role (mothers; fathers), depressive symptoms, and couple satisfaction. Material and Methods The sample included 42 preterm infants (16 ELBW, 26 VLBW) and their parents (42 mothers, 42 fathers). At 12 months (corrected age), parents completed the Infant Behavior Questionnaire-Revised (IBQ-R): specifically, we considered NA factor, including Sadness, Distress to limitations, Fear, Falling reactivity subscales. The Edinburgh Postnatal Depression Scale (EPDS) and Dyadic Adjustment Scale (DAS) were also administered to investigate parental depressive symptoms and quality of parental relationship, respectively. Results Analyses showed higher levels of NA in VLBW infants compared to ELBW ones (p&lt;.001); conversely, no differences between mothers and fathers emerged. Hierarchical regression showed that infant NA was predicted: in step 1 by VLBW condition (β =.36; p &lt;.001); in step 2 by own EPDS scores and their partners’ ones (β =.21, p &lt;.05; β =.36, p &lt;.005), even controlling for birth weight; in step 3 DAS scores did not show any effect, and only partner’s EPDS effect remained significant (β =.34, p &lt;.005). Conclusions Findings showed that, in the context of prematurity, both individual and relational-level risk factors predicted infants’ affective regulation difficulties, suggesting the need for intervention at individual, dyadic, and family level

SERPINB3 AS A PRO-INFLAMMATORY MEDIATOR IN THE PROGRESSION OF EXPERIMENTAL NON-ALCOHOLIC FATTY LIVER DISEASE.

Non-alcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease worldwide. In 20-30% of patients, NAFLD can progress into non-alcoholic steatohepatitis (NASH), eventually leading to fibrosis, cirrhosis and hepatocellular carcinoma development. SerpinB3 (SB3), a hypoxia-inducible factor-2a dependent cysteine protease inhibitor, is up-regulated in hepatocytes during progressive NAFLD and proposed to contribute to disease progression. In this study we investigated the proinflammatory role of SB3 by employing phorbol-myristate acetate-differentiated human THP-1 macrophages exposed in vitro to human recombinant SB3 (hrSB3) along with mice overexpressing SB3 in hepatocytes (TG/SB3) or knockout for SB3 (KO/SB3) in which NASH was induced by feeding methionine/choline deficient (MCD) or a cholinedeficient, L-amino acid defined (CDAA) diets. In vivo experiments showed that the induction of NASH in TG/SB3 mice was characterized by an impressive increase of liver infiltrating macrophages that formed crown-like aggregates and by an up-regulation of hepatic transcript levels of pro-inflammatory cytokines. All these parameters and the extent of liver damage were significantly blunted in KO/SB3 mice. In vitro experiments confirmed that hrSB3 stimulated macrophage production of M1-cytokines such as TNFa and IL-1b and reactive oxygen species along with that of TGFb and VEGF through the activation of the NF-kB transcription factor. The opposite changes in liver macrophage activation observed in TG/SB3 or KO/SB3 mice with NASH were associated with a parallel modulation in the expression of triggering receptor expressed on myeloid cells-2 (TREM2), CD9 and galectin-3 markers, recently detected in NASH-associated macrophages. From these results we propose that SB3, produced by activated/injured Q9 hepatocytes, may operate as a pro-inflammatory mediator in NASH contributing to the disease progression