Research portfolio: distress during pregnancy, an exploration of protective factors and offspring outcomes.
Background: Maternal mental health during pregnancy and its effects on offspring outcomes have received increased attention as a public health concern. This thesis aimed to examine and evaluate current research into the long term effects of maternal antenatal anxiety on offspring’s psychological development and markers of developmental psychopathology. This thesis also aimed to identify protective factors to parental distress during pregnancy. Self-compassion and adult attachment security have been found to be protective psychological factors for ameliorating stress in general adult samples. Therefore the empirical paper aimed to investigate the effect of these factors during the antenatal period. Method: A systematic literature review of prospective studies examining the effects of maternal antenatal anxiety on child psychopathology and neurodevelopment literature identified 16 relevant prospective studies. The empirical study recruited a general population sample of women and their partners during their second trimester of pregnancy. They completed self-report assessments of self-compassion, adult attachment security, mood and antenatal attachment. Neonatal birth outcome data was collected as follow-up data. Results: The systematic literature review results indicate that maternal antenatal anxiety can be measured and does have a negative impact on offspring development. The results also identified a broad risk phenotype, suggesting that interventions should not necessarily only be targeted at women reaching clinical caseness. The review highlighted a lack of specificity regarding possible psychological mechanisms of the relationship between maternal antenatal anxiety and offspring outcomes. The results of the empirical paper indicated that higher levels of self-compassion and attachment security were related to fewer self-reported symptoms of distress in mothers and their partners. Self-compassion was found to mediate the relationship between attachment security and distress in mothers. Neither antenatal attachment nor neonatal birth outcomes were significantly related to attachment security, self-compassion or levels of distress. Conclusions: The results of the systematic review should broaden public health concern. A need for future research is identified in terms of understanding the process of maternal-foetal programming, protective mediating factors and effective interventions. The role of self-compassion as a protective mediating factor is discussed in relation to identification and treatment of distress during the antenatal period.