Dolores Marin's research while affiliated with Hospital Universitario de Fuenlabrada and other places

The aim of this study is to evaluate the evolution of pain through pregnancy until after delivery, as well as to explore the mediating role of pregnancy worries in this evolution of pain. We conducted a longitudinal cohort study. The convenience sample was evaluated on four separate occasions: in the first trimester of pregnancy (pain), during the third trimester (pain and worry), during labor (pain), and after birth (< 24 h; pain). The final sample included 120 pregnant women with a mean age of 31.29 years (SD = 4.9; range = [22, 42 years]). The results evidenced changes in pain over time (F = 13.31, p < .001). Pain severity increased in the third trimester compared to the first trimester (t = − 4.60; 95% CI = [− 1.31, − 0.52]; p < .001), while pain during the third trimester and pain after delivery were comparable (t = − 0.94; 95% CI = [− 1.02, 0.36]; p = .35). Pain during labor was uncorrelated with all other pain measures, so it was not included in the model. The results of the mediation analyses indicated a total effect of pain during pregnancy (first and third trimester) and worry on pain severity after delivery (B = 0.35; SE = 0.14; t = 2.43; 95% CI = [0.06, 0.65]; p = .017). Pregnancy worries (B = 0.14; SE = 0.07; 95% CI = [0.06, 0.29]), but not pain during the third trimester (B = 0.03; SE = 0.12; 95% CI = [− 0.17, 0.31]) mediated the relationship between pain during the first trimester and pain after delivery. These results support the need to reduce worry in pregnant mothers, especially when pain during the first trimester is high, to reduce the risk of pain after delivery.

Purpose Posttraumatic stress (PTSD) and depression (PPD) are common mental disorders in the postpartum that constitute a threat both to the mother and the baby. It is unclear whether both disorders share similar antecedents, which is important to plan efficient interventions. The goal of this study was to examine the contribution of set of biopsychosocial predictors on both PTSD and PPD. Methods The study design was prospective. The study was conducted at Hospital Universitario de Fuenlabrada, a public university hospital located in the south of Madrid (Spain). The sample was composed of 116 pregnant women with low pregnancy risk. STROBE reporting guidelines were followed. Results The multivariate results show that psychopathology severity assessed during the first trimester (ß = 0.50, p < .001) and the Apgar score 5 min after delivery (ß = − 0.19, p = .030) were the two variables to significantly contribute to postpartum depressive symptoms. Conversely, only satisfaction with home care after delivery was independently associated with postpartum posttraumatic stress (ß = − 0.26, p = .016). The proposed model explained 21.8% of the variance of postpartum depressive symptoms (p = .041) and 27.1% of the variance of posttraumatic stress symptoms (p = .014). Conclusion Special attention should be given to shared and unique predictive factors of PDD and PTSD to develop effective prevention programs in perinatal care.

This study analyzes the moderating role of avoidant coping (in early pregnancy) in the relationship between postpartum depressive (PPD) symptoms and maternal perceptions about mother–baby relations and self-confidence. Participants were 116 low-risk obstetric mothers (mean age = 31.2 years, SD = 3.95, range 23–42) who received care and gave birth at a Spanish public hospital. Measurements were made at two points in time: at first trimester of pregnancy (maternal avoidance coping) and four months after childbirth (PPD and maternal perceptions). Avoidant coping was associated with the perception of the baby as irritable and unstable (p = 0.003), including irritability during lactation (p = 0.041). Interaction effects of avoidant coping and postpartum depression were observed on the perception of the baby as irritable (p = 0.031) and with easy temperament (p = 0.002). Regarding the mother’s self-confidence, avoidant coping was related to a lack of security in caring for the baby (p < 0.001) and had a moderating effect between PPD and mother’s self-confidence (i.e., lack of security in caring for the baby, p =0.027; general security, p = 0.007). Interaction effects showed that the use of avoidant coping in the mother exacerbated the impact of PPD on the early mother–infant relationship.

To analyze the influence of maternal personality (big five personality, coping and childbirth expectations) on birth satisfaction. A longitudinal prospective design was used with 116 pregnant women during November 2014-December 2015 at a public hospital (Madrid, Spain) with three assessment stages: first trimester of pregnancy (personality factors), third trimester (childbirth expectations and coping strategies) and 48 hours after childbirth (labor satisfaction). The highest childbirth satisfaction scores were for professional support, support from partner and overall satisfaction. Higher childbirth satisfaction scores were found for vaginal births than for cesarean sections or instrumental births. Childbirth expectation dimensions showed the highest number of associations with childbirth satisfaction. Significant correlations were found between neuroticism and home assessment, agreeableness and environment, and openness to experience and overall satisfaction. Significant positive correlations were found between positive reappraisal and continuity, and negative correlations between avoidance coping and home assessment. Regression analyses showed the predictive role played by the type of birth, and the caregiving environment as childbirth expectation, and positive reappraisal and avoidance as coping strategies. These findings have important implications for health professionals who provide assistance to pregnant women through holistic models which include the assessment and adjustment of childbirth expectations.

Introduction: The benefits of breastfeeding are well known for mother and child. Research about the predictive factors related to the initiation and maintenance of breastfeeding is of great interest to public health. Aim: To analyze the factors associated with the timely initiation of breastfeeding at immediate postpartum and the variables that facilitate their maintenance 4 months after birth. Materials and methods: A longitudinal prospective design was used, including four stages: first trimester of pregnancy (personality), third trimester (childbirth expectations, breastfeeding intention, pregnancy worries, and coping strategies), immediately after childbirth (initiation of breastfeeding and childbirth satisfaction), and 4 months after birth (continuation of breastfeeding). Results: A sample of 116 women took part in the study from the first trimester to 4 months after birth. Timely initiation of breastfeeding is associated with vaginal birth (p < 0.000) and with variables related to the absence of stress factors: fewer worries regarding childbirth (p = 0.009), higher satisfaction during birth in relation to holding the baby (p > 0.000), and the meeting of expectations (p = 0.017). These associations disappear when the type of birth is introduced. Maintenance of breastfeeding is associated with maternal personality and psychosocial variables: openness to experience (p = 0.007), increased worries about coping with the baby (p = 0.046), relationship with partner (p = 0.047), and overt emotional expression (p = 0.040). Conclusion: Different factors are associated with initiation and maintenance of breastfeeding. Specific prevention strategies are needed, aimed toward health care staff for improving breastfeeding initiation and to empower women during the entire pregnancy for breastfeeding maintenance.

Agreeableness is associated with good mental health during pregnancy. Although different studies have indicated that agreeableness is related to adaptive coping, this relation has scarcely been studied in pregnant women. The aim of this study was to analyze the possible differences between high and low agreeableness in relation to coping strategies and psychiatric symptoms in pregnant women. We conducted a longitudinal prospective study between October 2009 and January 2013. Pregnant women (n = 285) were assessed in the first trimester of pregnancy, and 122 of them during the third. Data were collected using the Coping Strategies Questionnaire, the Symptom Check List 90-R and the agreeableness subscale of the NEO-FFI. Using the SPSS 21 Statistics Package, binary logistic regression, two-way mixed ANOVA, and multiple regression analyses and a Sobel test were conducted. Higher levels of agreeableness were associated with positive reappraisal and problem-solving, and lower levels of agreeableness were associated with overt emotional expression and negative self-focused coping. Women with low agreeableness had poorer mental health, especially in the first trimester. These findings should be taken into account to improve women’s experiences during pregnancy. Nevertheless, given the scarcity of data, additional studies are needed.