Association of pregnancy experience with some maternal and neonatal outcomes: a longitudinal

Abstract

Abstract Introduction: Pregnancy is a very important transitional period that causes deep physical and emotional changes and requires many adaptations. The mother's experience during her pregnancy may affect the outcomes of childbirth such as postpartum depression and anxiety, childbirth experience, maternal-fetal attachment, and the mother's decision to start breastfeeding. Therefore, the purpose of this study is to determine the relationship between pregnancy experience and some maternal and newborn outcomes such as childbirth experience, depression, postpartum anxiety, mother-child bond, type ofchildbirth, breastfeeding, and anthropometric indicators of the newborn. Study method: The present study is a descriptive-analytical longitudinal study that was conducted on 228 pregnant women who referred to the health centers of Tabriz city. Random sampling was done during pregnancy from 28 to 36 weeks of pregnancy untile 6 weeks postpartum. During the pregnancy period, the participants took demographic questionnaires, Pregnancy Experience Scale (PES) and Maternal-Fetal Attachment Questionnaire (MFAQ = Maternal-Fetal Attachment Questionnaire) and in the postpartum period, childbirth experience questionnaires ( CEQ 2.0 = Childbirth Experience Questionnaire-2), Edinburgh Postnatal Depression Scale (EPDS), Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) and Mother-Child Bonding (PBQ) (Postpartum Bonding Questionnaire) were completed in an interview manner. Also, the infant's anthropometric indices and type of childbirth were recorded in the postpartum checklist based on the mother's childbirth record. Data were analyzed using SPSS-Version 24 software. In univariate analysis, Pearson's correlation coefficient was used to determine the relationship between pregnancy experience and childbirth experience, postpartum anxiety, attachment, bonding, and anthropometric indicators due to the normality of the distribution. Spearman's correlation test was used to determine the relationship between pregnancy experience and postpartum depression due to the non-normality of the distribution. In the multivariate analysis, the general linear model was used with the adjustment of personal-social and midwifery characteristics. Findings: The results of the study showed that the mean (standard deviation) of the pregnancy experience by separating the uplifts and hassles during pregnancy from the range of 0 to 30, 22.2 (4.5) and 11.1 (5.2) and the mean (standard deviation) of maternal-fetal attachment from the score range of 24 to 120, 91.0 (10.3), childbirth experience from the score range of 1 to 4, 2.8 (0.4), postpartum depression from the score range of 0 to 30, 8.1 (6.4), postpartum anxiety from the score range of 12 to 48, 22.3 (4.7), postpartum bonding from the score range Earnable of 0 to 125, it was 19/5 (7/6). After adjusting the effect of possible confounding variables, there was a statistically significant relationship between anxiety during pregnancy and postpartum depression (P<0.001) and postpartum anxiety (P=0.001); However, there was no statistically significant relationship between hassles (P=0.644) and uplifts (P=0.197) during pregnancy with childbirth experience, so that the probability of postpartum depression (P<0.001) in women who experienced hassles during pregnancy was increased by 1% (β = 0.01; 95% confidence interval = 0.01 to 0.02). The possibility of postpartum anxiety (P<0.001) increased by 22% in women who experienced anxiety during pregnancy (β = 0.22; 95% confidence interval = 0.09 to 0.35). The results of the general linear model by adjusting the personal-social characteristics of midwives showed that the average score of maternal-fetal attachment (P<0.001) was higher among women who experienced uplifts during pregnancy (β =1/14; 95% confidence interval = 0.87 to 1.41). Maternal-fetal attachment score increased with increasing gestational age (P<0.001) (β =0.74; 95% confidence interval=0.32 to 1.15). Conclusion: The results of the study showed a strong relationship between women's pregnancy experience and some psychological consequences during pregnancy and postpartum period, such as maternal-fetal attachment, type of childbirth and depression and postpartum anxiety. Therefore, it is recommended to plan interventions to make pregnancy a positive and pleasant experience for mothers and reduce the prevalence of postpartum depression and anxiety.