Journal article
Antenatal psychobiological predictors of psychological response to childbirth.
- Alder J University Hospital Basel, University of Basel, Basel, Switzerland. jalder@uhbs.ch
- Breitinger G
- Granado C
- Fornaro I
- Bitzer J
- Hösli I
- Urech C
- 2011-12-07
Published in:
- Journal of the American Psychiatric Nurses Association. - 2011
Adaptation, Psychological
Adult
Anxiety
Delivery, Obstetric
Fear
Female
Humans
Hydrocortisone
Interview, Psychological
Longitudinal Studies
Neonatal Nursing
Parturition
Predictive Value of Tests
Pregnancy
Prenatal Care
Prospective Studies
Stress, Psychological
Surveys and Questionnaires
Switzerland
English
BACKGROUND
Several psychological and obstetric predictors of a negative childbirth experience and traumatic response to delivery have been identified. However, the influence of antepartum physiological stress parameters has not been elucidated.
OBJECTIVE
The study includes an exploratory analysis of the associations of fear of delivery, antenatal basal and reactive activity of the hypothalamic-pituitary-adrenal axis, and obstetric outcomes, with childbirth experience and posttraumatic avoidance in the postpartum period.
DESIGN
This was a prospective study with two antenatal measurements and a final assessment during the first week postpartum. An experimental condition with a standardized stressor (Trier Social Stress Test) was included in the design to study psychobiological stress response as a predictor of traumatic birth and posttraumatic avoidance.
RESULTS
Linear regression analyses show independent associations of fear of delivery and more pronounced antenatal cortisol awakening response with a more negative childbirth experience. Fear of delivery was mediated by state anxiety after stress exposure, which, together with cortisol awakening response, explained 16% of the variance in the outcome of a more negative childbirth experience. Finally, antenatal fear of delivery and a negative childbirth experience both predicted higher avoidance scores during the first week postpartum.
CONCLUSIONS
The associations found in this study can improve identification during pregnancy of women at risk for negative psychological response to childbirth. For these women, the provision of supportive care during pregnancy should be evaluated.
Several psychological and obstetric predictors of a negative childbirth experience and traumatic response to delivery have been identified. However, the influence of antepartum physiological stress parameters has not been elucidated.
OBJECTIVE
The study includes an exploratory analysis of the associations of fear of delivery, antenatal basal and reactive activity of the hypothalamic-pituitary-adrenal axis, and obstetric outcomes, with childbirth experience and posttraumatic avoidance in the postpartum period.
DESIGN
This was a prospective study with two antenatal measurements and a final assessment during the first week postpartum. An experimental condition with a standardized stressor (Trier Social Stress Test) was included in the design to study psychobiological stress response as a predictor of traumatic birth and posttraumatic avoidance.
RESULTS
Linear regression analyses show independent associations of fear of delivery and more pronounced antenatal cortisol awakening response with a more negative childbirth experience. Fear of delivery was mediated by state anxiety after stress exposure, which, together with cortisol awakening response, explained 16% of the variance in the outcome of a more negative childbirth experience. Finally, antenatal fear of delivery and a negative childbirth experience both predicted higher avoidance scores during the first week postpartum.
CONCLUSIONS
The associations found in this study can improve identification during pregnancy of women at risk for negative psychological response to childbirth. For these women, the provision of supportive care during pregnancy should be evaluated.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1177/1078390311426454
- PMID 22142978
- Persistent URL
- https://sonar.ch/global/documents/92583
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