Relationship satisfaction and family routines of young parents before and during the first year of the COVID-19 pandemic: A latent growth curve analysis.

With the onset of the COVID-19 pandemic, parents had to reorganize their family routines under many external stressors (e.g., limited external childcare), which could have negatively affected their relationship satisfaction. This study aimed to examine the changes in relationship satisfaction of young parents from pre-pandemic times up to the second wave of the COVID-19 pandemic in Germany in December 2020 and whether these changes were different for mothers and fathers. Additionally, the role of perceived pandemic-related stress and changes in family routines was investigated. Data from 564 participants from DREAMCORONA, a sub-study of the prospective longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM), were analyzed. Relationship satisfaction was assessed at three measurement points (T0: pre-pandemic, i.e., August 2018-March 2020; T1: May-June 2020; T2: October-December 2020). To estimate changes in relationship satisfaction over time, Latent Growth Curve Models were calculated. Changes in family routines (i.e., changes in the division of housework and childcare from T0 to T1 as well as the availability of external childcare facilities at T1) and perceived pandemic-related stress at T1 were used as predictors. The models were adjusted for education and number of children per household. There was no significant change in relationship satisfaction over time, with no differences between mothers and fathers. The multi-group model revealed that changes in the division of housework and childcare predicted changes in relationship satisfaction in mothers, but not in fathers. For mothers, doing more housework than before the pandemic was negatively associated with changes in their relationship satisfaction over time. Additionally, reporting that their partner did more childcare than before the pandemic was positively associated with the relationship satisfaction of mothers. Our results indicate no general negative prospective association between the COVID-19 pandemic and parental relationship satisfaction over time. Nevertheless, our findings highlight the importance of the division of housework and childcare for mothers' relationship satisfaction and how pandemic-related changes in family routines alter this association.

Does parental mental health mediate the association between parents' perceived stress and parent-infant bonding during the early COVID-19 pandemic?

BACKGROUND: The spread of the COVID-19 virus was declared a pandemic in March 2020. New restrictions such as 'lockdowns' and 'social distancing' created challenges for individuals' work-life balance, financial situation, family life, and physical and mental health. The global population's stress levels rose in response to these changes, leading to a widespread deterioration of mental health. One group particularly affected was parents of infants and very young children. Poor parental mental health may disrupt parent-infant bonding, with negative consequences for infant well-being and development. AIMS: To consider parent-infant bonding in relation to parents' perceived stress and psychological distress during the first lockdown, and to examine whether associations of stress with parent-infant bonding were mediated by parental mental health. METHODS: DREAMCORONA (n = 738: 471 mothers and 267 partners) is a sub-study of the prospective German cohort study 'DREAM'. The SPSS modelling tool PROCESS was used to assess whether parental mental health mediated the relationship between parents' perceived stress response to the COVID-19 pandemic and parent-infant bonding, while controlling for covariates. RESULTS: Higher levels of parental stress were strongly associated with higher levels of depression, anxiety, and aggression symptoms for both parents. In addition, there was a significant relationship between parents' self-reported stress levels and parent-infant bonding. This relationship was mediated by symptoms of depression and anxiety for fathers and by symptoms of anger-hostility for both parents. CONCLUSION: Increased parental stress during the early pandemic was associated with poorer parent-infant bonding. This has important implications for the management of any future public health crises.

Childbirth-related posttraumatic stress symptoms - examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma.

Evidence has linked alterations of the endocannabinoid system with trauma exposure and posttraumatic stress disorder (PTSD). Childbirth-related PTSD symptoms (CB-PTSS) affect about every eighth woman and can negatively influence the entire family. While aetiological models of CB-PTSD include psychological risk factors such as maternal trauma history and negative subjective birth experience (SBE), they lack biological risk indicators. We investigated whether lifetime trauma and CB-PTSS were associated with long-term endocannabinoid concentrations during pregnancy. Further, we tested endocannabinoids as mediators between lifetime trauma and CB-PTSS and whether SBE moderated such mediational paths. Within the prospective cohort study DREAMHAIR, 263 expectant mothers completed trauma assessments and provided hair samples for quantification of long-term endocannabinoid levels (anandamide [AEA], 2-arachidonoylglycerol [1-AG/2-AG], and N-acyl-ethanolamides [NAE]) prior to their anticipated birth date. Two months postpartum, CB-PTSS and SBE were measured. Regression models controlling for relevant confounders showed no association between lifetime trauma and hair endocannabinoids during pregnancy, yet higher number of lifetime trauma events and lower hair AEA were significantly associated with CB-PTSS, with the latter finding not remaining significant when Bonferroni corrections due to multiple testing were applied. While hair AEA did not mediate the association between lifetime trauma and CB-PTSS, the effect of lower hair AEA on CB-PTSS was stronger upon negative SBE. Results suggest greater lifetime trauma and reduced maternal hair AEA during pregnancy may be associated with increased risk for CB-PTSS, particularly upon negative SBE. Findings confirm lifetime trauma as a CB-PTSS risk factor and add important preliminary insights on the role of endocannabinoid ligand alterations and SBE in CB-PTSS pathology.

Changes in relationship satisfaction in the transition to parenthood among fathers.

To date, research on the transition to parenthood and associated changes in relationship satisfaction (RS) has focused predominantly on mothers with their firstborn. This study targeted fathers to investigate their trajectories of RS with a particular focus on emerging differences between first- and second-time fathers. It furthermore considered various predictors such as the role of age, education, income, duration of relationship, marital status, child's biological sex, and child temperament. Data from a total of 606 fathers from the prospective longitudinal cohort study DREAM were analyzed. The analyses included assessments of four measurement time points (T1: prepartum; T2-T4: postpartum) over a period of more than 2 years. Latent growth curve modeling was applied with RS as the dependent variable and number of children as one of eight predictors of growth over time. First-time fathers showed higher initial RS, however experienced a steeper decline in the transition to parenthood than second-time fathers. At 8 weeks postpartum, first-time fathers still reported higher RS than second-time fathers. While RS continued to decline for first-time fathers up until 14 months postpartum, second-time fathers experienced an increase in RS. At 14 months and 2 years postpartum, second-time fathers showed higher RS scores than first-time fathers. Similar to first-time mothers, first-time fathers seem to experience a stronger RS decline during the transition to parenthood than second-time fathers, suggesting that especially couples becoming parents for the first time should be prepared for expected changes in their relationship.

Maternal postpartum depressive symptoms: The predictive role of objective and subjective birth experience and hair glucocorticoids.

BACKGROUND: Having a negative childbirth experience is a known risk-factor for developing postpartum depression (PPD). Alterations of the hypothalamus-pituitary-adrenal (HPA)-axis have been discussed as a potential underlying mechanism. However, research on the association between negative birth experiences and long-term integrated glucocorticoids (GCs) is lacking. This study aimed to examine whether objective and subjective birth experience predicted long-term GCs and PPD symptoms. METHODS: Measures of objective and subjective birth experience, PPD symptoms, and hair strands for the assessment of hair cortisol concentrations (HairF), hair cortisone concentrations (HairE), and HairF/HairE ratio, were provided eight weeks after childbirth by 235 mothers participating in the study DREAMHAIR. RESULTS: A negative objective birth experience predicted a higher HairF/HairE ratio but was not associated with HairF or HairE. The subjective birth experience did not explain additional variance in hair GCs but was a significant predictor for PPD symptoms. A higher HairF/HairE ratio predicted PPD symptoms when controlling for prepartum depressive symptoms and number of lifetime traumatic events. LIMITATIONS: Analyses were based on a relatively homogeneous sample and women reported in general positive birth experiences and low levels of depressive symptoms. Therefore, results should be applied to the broader population with caution. CONCLUSIONS: Our results suggest that negative objective birth experience is associated with an altered HairF/HairE ratio, which in turn, seems to be a promising biomarker to identify women at risk for developing PPD. A negative subjective birth experience may be less critical for alterations of the HPA-axis but remains an essential risk factor for PPD.

The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM.

BACKGROUND: The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS: This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS: Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS: The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.

Psychosocial work stress and parent-child bonding during the COVID-19 pandemic: clarifying the role of parental symptoms of depression and aggressiveness.

BACKGROUND: Parental work stress and impaired mental health seem to have intensified during the current COVID-19 pandemic. Both can have a negative impact on parent-child bonding: psychosocial work stress in the course of a spillover effect from work to family and symptoms of impaired mental health as part of a crossover effect from parent to child. This potentially affects the child's development in the long term. METHOD: This cross-sectional study examined the relationship between psychosocial work stress and parent-child bonding during the early COVID-19 pandemic (May-June 2020). Symptoms of depression and aggressiveness were considered as mediators of this relationship. The sample consisted of employees in Eastern Germany (n = 380; 42.9% mothers, 57.1% fathers), aged 24-55 years, with children aged 0-36 months. RESULTS: In the total sample, an association was only found after adjusting for potential confounders, indicating that higher psychosocial work stress is associated with weaker bonding between the parent and child (ß = 0.148, p = .017, 95% CI [0.566, 5.614]). The separate analyses for mothers and fathers did not reveal a statistically significant relationship between psychosocial work stress and parent-child bonding. In the total sample, the higher the psychosocial work stress was, the higher were the parental symptoms of depression (ß = 0.372, p < .001, 95% CI [3.417, 5.696]) and aggressiveness ß = 0.254, p < .001, 95% CI [1.008, 3.208]). The mental health symptoms in turn were related to weaker parent-child bonding (symptoms of depression ß = 0.320, p < .001, 95% CI [0.345, 0.749]; symptoms of aggressiveness ß = 0.394, p < .001, 95% CI [0.697, 1.287]). The results furthermore suggested that parental mental health symptoms mediate the association between psychosocial work stress and parent-child bonding (symptoms of depression, ab = 2.491, 95% CI [1.472, 3.577] and of aggressiveness, ab = 2.091, 95% CI [1.147, 3.279]). The mediation effect was also found in the separate analyses for the mothers and fathers. DISCUSSION: The results of this study during the early COVID-19 pandemic in Germany highlight the importance of prevention as well as intervention measures in relation to psychosocial work stress that may play a debilitating role in the context of family relationships. In addition, the results suggest that both employers and employees should be made aware of the importance of psychosocial work stress, as it can have a negative impact on mental health, which in turn may have a major influence on family relationships.

The association between maternal symptoms of depression and hair glucocorticoids in infants across the perinatal period.

BACKGROUND: Maternal symptoms of depression constitute an early adversity for infants that is considered to exert its effects via the maternal-placental-fetal neuroendocrine axis. Previous research implicates associations between maternal prenatal symptoms of depression and infants' glucocorticoid (GC) levels shortly after birth. To date, associations have not been investigated in the early postnatal period. The current study aimed to investigate the influence of maternal perinatal symptoms of depression on infants' neonatal and postnatal hair GCs providing a retrospective reflection of integrated cortisol secretion in the intrauterine and early postnatal period, respectively. METHODS: As part of a prospective cohort study, hair samples of infants were taken up to two weeks after delivery (N = 152) and again eight weeks after delivery (N = 165). Liquid chromatography-tandem mass spectrometry was used to determine hair cortisol and cortisone in scalp-near 2-cm hair segments. Maternal symptoms of depression were assessed during pregnancy and eight weeks postnatally based on the Edinburgh Postnatal Depression Scale. RESULTS: Higher maternal prenatal symptoms of depression showed a significant association with higher infants' neonatal hair cortisol, when controlling for confounding variables (i.e., gestational age, mode of delivery, parity, storage time, pregnancy complications). A non-significant trend for this effect was found for the hair cortisol-to-cortisone ratio while no effect occurred for hair cortisone. No association of maternal postnatal symptoms of depression with infants' postnatal hair GCs was observed. Further exploratory analyses revealed no relationship between a change of maternal prenatal to postnatal symptoms of depression with the change from infants' neonatal to postnatal hair GC levels or postnatal hair GCs. CONCLUSION: Our results suggest that maternal prenatal symptoms of depression are associated with dysregulated infants' hair cortisol levels mainly incorporated in the intrauterine period which, in turn, might contribute to increased susceptibility for later diseases. However, no relationship was observed in infants' hair samples additionally reflecting hair GCs of the early postnatal period. Future studies should consider research on associations between maternal symptoms of depression and infants' hair GCs also later in life and take into account additional risk factors with potential impacts on GC secretion during early infancy.

Mental health of working parents during the COVID-19 pandemic: can resilience buffer the impact of psychosocial work stress on depressive symptoms?

BACKGROUND: The COVID-19 pandemic has confronted working parents with an accumulation of stressors regarding changes in work, family, and social life, putting their mental health at risk. Stressors include altered working conditions such as working from home or changes in working hours as well as the difficulty to reconcile work and childcare due to the closure of childcare facilities. The present study examined the relationship of psychosocial work stress (i.e., work-privacy conflict and effort-reward imbalance at work) and depressive symptoms in working parents and whether this association was moderated by individual resilience. METHODS: Data of the present study (n = 452) were collected in Germany between May and June 2020 as part of the DREAMCORONA study. A subsample of working mothers (n = 191) and fathers (n = 261) completed the subscale for work-privacy conflict (WPC) of the Copenhagen Psychosocial Questionnaire, the Effort-Reward Imbalance (ERI) Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression analyses including moderation were performed, controlling for gender, working hours per week, and a lifetime history of depression as potential confounders. RESULTS: Both WPC (ß = 0.336, p < .001) and ERI (ß = 0.254, p < .001) were significantly associated with depressive symptoms. Resilience moderated the relationship between ERI and depressive symptoms (ß = - 0.101, p = .018), indicating that higher resilience weakened the relationship. However, this effect was not found regarding the relationship between WPC and depressive symptoms (ß = 0.055, p = .167). CONCLUSIONS: The results highlight the need for measures to reduce psychosocial work stressors such as WPC and ERI during the COVID-19 pandemic on the one hand and to promote resilience on the other hand. The findings partially support the potential protective role of resilience buffering the association between psychosocial stress and mental health in working parents. Longitudinal studies are needed to confirm this effect.

The impact of postpartum obsessive-compulsive symptoms on child development and the mediating role of the parent-child relationship: A prospective longitudinal study.

Background: The first 2 years of life are a particularly sensitive period for the parent-child relationship as well as a healthy, age-appropriate child development. Both have been shown to be linked to postpartum depressive and anxiety symptoms, while the role of obsessive-compulsive symptoms, which are also common, is still largely understudied. In addition, fathers have been neglected in this area of research. This study, which includes both mothers and fathers, aims to investigate the longitudinal associations between postpartum obsessive-compulsive symptoms and different domains of child development, as well as the mediating role of the parent-child relationship. Methods: Data were drawn from the prospective longitudinal study DREAM, with 674 mothers and 442 fathers from the general population completing self-report questionnaires at four measurement points. Longitudinal associations between parental postpartum obsessive-compulsive symptoms 8 weeks postpartum, the parent-child relationship 14 months postpartum, and child development 24 months postpartum were investigated using regression and mediation analyses. A number of potential confounding variables were considered, i.e., age, academic degree, postpartum depressive and anxiety symptoms of the parents, preterm birth and temperament of the child, as well as COVID-19 pandemic-driven adversities. Results: When adjusting for confounders, neither maternal nor paternal postpartum obsessive-compulsive symptoms had adverse effects on the respective parent-child relationship and child development. Further, no mediating role of the parent-child relationship between parental postpartum obsessive-compulsive symptoms and child development could be confirmed. Instead, we found that the mother- and father-child relationship were differentially related to specific child developmental domains. For mothers, a poorer mother-child relationship was prospectively related to poorer fine motor development. For fathers, a poorer father-child relationship prospectively predicted a poorer overall development as well as poorer gross motor, fine motor, problem-solving, and personal-social development. Conclusion: Our results suggest that negative effects on the parent-child relationship and child development may only become apparent in full-blown postpartum obsessive-compulsive disorder. Given the differential impact on specific developmental domains, our findings also suggest that it is crucial to consider both parents in clinical practice as well as in future research, rather than focusing only on the mother-child dyad.

Prospective associations between prepartum physical activity, birth experience, and maternal depressive symptoms in the postpartum period: Insights from the population-based DREAM cohort study.

BACKGROUND: This study aims to examine whether physical activity (PA) before and during pregnancy and birth experience predict incident postpartum depressive (PPD) symptoms. Because PA may increase endurance and feelings of physical control, it may contribute to a positive birth experience and birth experience may mediate the association between PA before and during pregnancy and PPD symptoms. METHODS: The study is part of the prospective-longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Participants were n = 1,254 (expectant) mothers. PA was assessed during pregnancy, birth experience and PPD symptoms 8 weeks postpartum. Multiple regression analyses were performed, including potential confounders. RESULTS: A negative birth experience was linked to PPD symptoms, when controlling for relevant confounders. There was no evidence for a link between PA before and during pregnancy and birth experience or between PA during pregnancy and PPD symptoms. PA at low and at vigorous intensity before pregnancy was associated with PPD symptoms, but not when controlling for confounders. Because PA was not associated with birth experience, no mediation analysis was performed. LIMITATIONS: The current sample was relatively homogenous (i.e., mostly German native speakers, primiparous, highly educated). Birth experience was assessed retrospectively at 8 weeks following birth. CONCLUSIONS: Our results highlight the importance of the birth experience in the development of PPD symptoms. Promoting a positive birth experience represents a promising approach to prevent PPD symptoms. Further research on the association between PA and PPD symptoms is warranted.

Birth Experience Mediates the Association Between Fear of Childbirth and Mother-Child-Bonding Up to 14 Months Postpartum: Findings From the Prospective Cohort Study DREAM.

OBJECTIVE: To explore the longitudinal associations between prepartum fear of childbirth (FOC), birth experience, and postpartum mother-child-bonding, and the potential mediator role of the birth experience. DESIGN: Women from the prospective cohort study DREAM completed questionnaires during pregnancy, 8 weeks, and 14 months after the birth. PARTICIPANTS: A community sample of n = 645 pregnant women from a large city in Eastern Germany participated in the study. RESULTS: In a regression analysis, FOC predicted negative birth experience (ß = 0.208, p < 0.001) which in turn predicted poorer mother-child-bonding both at 8 weeks (ß = 0.312, p < 0.001) and 14 months postpartum (ß = 0.200, p < 0.001). FOC also predicted mother-child-bonding at 14 months postpartum (ß = 0.098, p < 0.05). Of note, this association was mediated by birth experience both at 8 weeks, indirect effect ab = 0.065, 95% CI [0.036, 0.098], and 14 months postpartum, indirect effect ab = 0.043, 95% CI [0.023, 0.067]. These effects remained stable even when adjusting for potential confounders. KEY CONCLUSIONS: This study suggests that the association between FOC and mother-child-bonding is mediated by birth experience, pointing to the importance of a woman's positive subjective experience. IMPLICATIONS FOR PRACTICE: Findings reveal two targets for peripartum interventions for women at risk for poor mother-child-bonding, namely the implementation of FOC screenings during pregnancy, and birth experience as mediating factor between FOC and mother-child-bonding. Focusing on the mother's subjective birth experience could aid to identify women at risk for impaired bonding who might need additional support.