Hum. Reprod. Advance Access published online on June 1, 2007
Human Reproduction, doi:10.1093/humrep/dem123
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Impact of a multiple, IVF birth on post-partum mental health: a composite analysis
1 Division of Psychiatry, Queen's Medical Centre, Nottingham NG7 2UH, UK 2 Institute of Work, Health and Organisations, The University of Nottingham, Nottingham NG7 2RQ, UK 3 Centre for Assisted Conception, The Park Hospital, Nottingham NG5 8RX, UK
4 Correspondence address. Tel: +44-(0)-115-8230418; Fax: +44-(0)-115-8230433; E-mail: charlotte.sheard{at}nottingham.ac.uk
BACKGROUND: This study explored the impact of a multiple IVF birth on maternal mental health in the early post-partum period.
METHODS: A prospective study of 207 women who had conceived following IVF treatment and followed up at 6 weeks post-partum. Mothers rated their mood using the Edinburgh postnatal depression scale (EPDS) and their baby's behaviour using the Unsettled and Irregular Behaviour scale. Mothers' emotional well-being was explored using theme analysis of semi-structured telephone interviews.
RESULTS: Of the 175 (84.5%) followed up post-partum, 56 (32%) had a multiple birth (7 triplets, 49 twins). Nearly 16% of mothers in the multiple group scored >12 on the EPDS indicating clinically significant symptoms, which represented a 3-fold increased risk compared to mothers of singletons (Odds ratio = 3.4, Confidence Interval = 1.011–11.618, P = 0.048). Unsettled and irregular infant behaviour was another independent risk factor. Qualitative analysis of interviews identified 12 themes. Mothers of multiples were more likely to express negative themes including ‘tiredness’ (P < 0.01), ‘feelings of stress/depression’ (P < 0.05) and ‘questioning parenthood’ (P < 0.05). Mothers of singletons were more likely to be ‘feeling wonderful’, reflecting their delight in parenthood (P < 0.05).
CONCLUSIONS: Mothers of multiples are at increased risk of poorer emotional well-being. Clinicians should focus on the psychological benefits of a singleton birth.
Key words: multiple birth/IVF/emotional well-being/theme analysis/twins
Submitted on September 12, 2006; resubmitted on April 2, 2007; accepted on April 16, 2007.
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