Journal of Midwifery & Reproductive health
Volume:3 Issue: 2, Apr 2015

Mother-infant bonding and interactions after childbirth are shaped by maternal-fetal attachment during pregnancy. Although many studies have shown the positive correlation between maternal-fetal attachment and mother-infant attachment behaviors, some controversial studies have shown otherwise. Therefore, this study aimed to evaluate the correlation between maternal-fetal attachment and mother-infant attachment behaviors in primiparous women. This descriptive correlational study was conducted on 100 primiparous women, referring to the selected heath care centers of Mashhad. Data were collected using Cranley''s maternal–fetal attachment scale, Avant’s mother-infant attachment tool, Edinburgh postnatal depression scale, and a demographic/obstetric questionnaire including demographic data, obstetric information, delivery outcomes, and postpartum data. Pregnant women with a gestational age of 35-41 weeks, who met the inclusion criteria, completed Cranley''s questionnaire, as well as the demographic/obstetric questionnaire. Four and eight weeks after delivery, the subjects were asked to complete the Edinburgh questionnaire and postpartum information; then, they were asked to breastfeed their infants on a chair in a quiet place for 15 minutes. The researcher observed the mothers’ behaviors toward their neonates. For data analysis, descriptive and analytical tests were performed, using SPSS version 16. There was a direct positive relationship between maternal-fetal attachment and mothers’ emotional behaviors toward infants four and eight weeks after delivery. However, four and eight weeks after childbirth, no significant correlation was found between maternal-fetal attachment and mothers’ caring behaviors. According to the findings, maternal-fetal attachment is one of the most important factors for mother-infant attachment. These findings could be applied for enriching mother-infant attachment behaviors during pregnancy.

Gestational nausea and vomiting are positively correlated with stress and stress is negatively associated with social support. Due to advances in technology, telephone has become the most accessible device for home-based support. This study aimed to determine the effects of telephone support on stress and perceived social support in primiparous women experiencing nausea and vomiting during the first half of pregnancy. This clinical trial was conducted on 60 healthy pregnant women suffering from mild nausea and vomiting in the first half of pregnancy. They were randomly assigned to intervention (n=30) and control (n=30) groups. The intervention group received social support twice a week for a period of four weeks. Each phone conversation lasted around 15-20 minutes. During these conversations, dietary and lifestyle changes during pregnancy, as well as ways to reduce fatigue and improve psycho-emotional status, were discussed. The control group received routine care. Data were collected using a demographic questionnaire, Multidimensional Scale of Perceived Social Support, and Visual Analogue Scale for stress. Independent t-test and paired test were performed, using SPSS version 16. No significant difference was found in the mean scores of stress in two groups at the beginning and end of the study (P=0.052). However, social support score at the beginning of the study was significantly different from that at the end of the study in both groups (P=0.036). It is recommended that telephone support be integrated into the routine care of women with nausea and vomiting in order to improve their perceived social support and decrease their stress.

Decreased sleep quality is a common complaint during pregnancy. Relaxation is one of the non-pharmaceutical treatments for sleep disorders. Different techniques could have different impacts on various biological and mental stressors. Therefore, this study aimed to compare the effects of progressive muscle relaxation and guided imagery on the sleep quality of primigravida women. This three-group clinical trial was conducted on 100 primigravida women, referring to Mashhad health care centers in 2014. All women, who met the inclusion criteria, were randomly assigned to three groups: progressive muscle relaxation, guided imagery, and control groups. The intervention groups performed the exercises twice a day for a period of four weeks at home after two sessions of relaxation training (held during two weeks). Then, the quality of sleep was measured using Pittsburgh Sleep Quality Index. For data analysis, ANOVA, Kruskal-Wallis, paired t-test, and post-hoc test were performed, using SPSS version 11.5. The total score of sleep quality and its components (except use of sleep medication) was significantly lower after the intervention, compared to the pre-intervention period in progressive muscle relaxation and guided imagery groups (P<0.001). Both relaxation techniques were effective in improving sleep quality and its components (P<0.001). However, the effect of guided imagery was more significant than progressive muscle relaxation (P=0.015). Both guided imagery and progressive muscle relaxation positively affected the sleep quality of primigravida women, although the effect of guided imagery was more significant. It is recommended to integrate guided imagery into pregnancy care for primigravida women with sleep disorders.

Clinical definition of depression disorder has changed and made precise over the time. Some studies reported depression during pregnancy was more common than postpartum depression. The purpose of this study is to evaluate prevalence and factors that may be contributing to the depression in pregnant women in Sarakhs city. This cross sectional study was conducted on 300 pregnant women who was referred to the health centers in Sarakhs city, Razavi Khorasan province, Iran, 2011. Beck''s Depression inventory questionnaire and demographic questionnaire were completed by trained interviewers. Data were analyzed by SPSS software version 16 by using T-test, man-Whitney, Chi-square tests. P-value less than 0.05 were considered as statistically significant. Prevalence of depression in pregnant women was 47.5% which the most of them had moderate depression. In this assay, depression significantly was related to mother age (P=0.02), her occupations (P=0.009), family income (P=0.04), ethnicity (P=0.03), place of living (P=0.01), number of children (P=0.001), unwanted pregnancy (P=0.001), and history of parities (P=0.001). Prevalence of depression during pregnancy makes it more important for providing antenatal care and supporting such women in seeking help. This study indicating the importance of the psychological state of pregnant women, screening depression with accurate assessment of the symptoms and diagnosis it as early as possible.

Domestic violence is an individual and social damage, which is affected by personality traits and can cause a crisis for the mental health of individuals; thus, the present study aimed to investigating personality traits and its impact on mental health of battered women in Tehran, 2013. In this cross-sectional study, 196 married women who referred to Tehran Legal Medicine Center in 2013 were selected based on simple sampling method, and then were studied based on General Health Questionnaire (GHQ-28) and the NEO Five Factor Inventory (NEO-FFI). In this cross-sectional study, the data were analyzed with the Pearson Correlation Test using the SPSS-16. The present study revealed that statistically mental health has a significant and positive correlation with neuroticism personality trait (r=0.318, P<0.001), while it has a significant but negative correlation with extraversion personality trait (r=-0.280, P<0.001), agreeableness (r=-0.201, P=0.002), and conscientiousness (r=-0.265, P=0.001). Although mental disorder on the part of battered women paves the way for violence against them, learning personality traits along with individual and social factors among women can significantly contribute to prevention, screening and necessary treatments by experts and authorities.

One of the factors of affecting maternal anxiety is a history of fetal death or neonatal death. This anxiety affects fetal and maternal health. By consideration the impact of anxiety on fetal and maternal health and the lack of protective activities in this field, this study was done to determine the impact of adaptation with pregnancy educational package on anxiety and maternal fetal attachment in pregnant women with a history of baby loss. 60 pregnant women were selected in two studying group with previous fetal death or neonatal death by convenience sampling and were randomly assigned to control and intervention groups. Educational package includes: teaching session''s adaptation with pregnancy in four 60- minutes, training booklet and CD, maternal educating was beginning from 23 week gestation. Maternal anxiety measured before and after the intervention in both groups using the Mann-Whitney and Kruskal-Wallis test and STAI anxiety questionnaire was compared. visible and invisible Anxiety scores had not significant difference between two groups pre-intervention. Immediately after the intervention visible and invisible anxiety scores in the experimental group was better than the control group (P ≤ 0.05, P ≤ 0.05 vice versa). Adaptation with pregnancy educational package reduces anxiety in pregnant women with a history of fetal or neonatal death. So, due to reduce the damaging effects of anxiety on the mother and fetus in pregnancy, holding effective proceeding for reducing anxiety such as: holding training courses are recommended for pregnant women with a history of fetal or neonatal death.

Pre-pregnancy obesity is considered as a significant predictor for neonatal and maternal morbidity and mortality. Several studies have indicated conflicting associations between body mass index (BMI) and pregnancy outcomes. This study aimed to evaluate the effects of pre-pregnancy BMI on adverse pregnancy outcomes. Thiscohort study was conducted from 2010 to 2013 in Qazvin province, Iran. BMI was measured in a total of 1376 pregnant women before their 12th week of pregnancy. The subjects were followed-up until the termination of their pregnancy and childbirth. Data collection was performed through checklists prepared by the researchers, which consisted of three parts: demographic features, obstetric history, and subsequent pregnancy outcome. For data analysis, Chi-square, ANOVA and Mann-Whitney tests were performed, using SPSS version 16. In addition, adjusted odds ratio (OR) and 95% confidence interval (CI) were measured. The risk of preeclampsia (OR: 5.36, CI: 2.505-11.49), gestational diabetes mellitus (OR: 5.092, CI: 1.67-15.46), cesarean section (OR: 1.959, CI: 1.37-2.79), and large for gestational age (OR: 4.735, CI: 1.402-15.98) was higher in overweight (25≤BMI≤29.9 kg/m2) and obese groups (BMI>30 kg/m2), compared to women with below-normal and average weight. Pre-pregnancy obesity is strongly associated with certain pregnancy complications and perinatal conditions. Therefore, these complications implicate the need for pre-pregnancy counseling and weight loss in this group of women.

Many parents do not believe in their ability to fulfill their parental responsibilities. Parental self-efficacy is crucial to parents’ sense of well-being and is considered a predictor for quality of life. However, evidence is scarce on the factors that influence parents’ perception of efficacy. Therefore, this study aimed to investigate the predictors for parental self-efficacy in the early postpartum period. This descriptive analytical study was conducted on 150 primiparous women referring to the health care centers of Mashhad during their early postpartum months. For data collection, we used demographic questionnaires, Bates’ Infant Characteristics Questionnaire (ICQ), Scale of Perceived Social Support, Reece’s parent expectations survey (PES), and Edinburgh Postnatal Depression Scale (EPDS). For data analysis, independent T-test, one-way ANOVA, Pearson’s correlation coefficient, and stepwise regression were performed, using SPSS version 16. In this study, a significant association was observed between self-efficacy scores and the parents’ income, educational status, depression, and infant’s gender. Furthermore, there was a significant correlation between self-efficacy scores and infant’s characteristics, mother’s satisfaction with childbirth experience, perceived support from friends, infant’s perceived temperament, infant’s gender, mother’s educational level, and depression, which could predict 26.1% of parental self-efficacy. According to the results of this study, the most significant predictors of maternal self-efficacy during the early postpartum months were maternal depression and educational status, infant’s gender, and infant’s characteristics.