Medicine

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    Correction to: Prenatal attachment: Using measurement invariance to test the validity of comparisons across eight culturally diverse countries
    (Springer, 2021) Foley, S.; Hughes, C.; Murray, A.L.; Baban, A.; Fernando, A.D.; Madrid, B.; Osafo, J.; Sikander, S.; Abbasi, F.; Walker, S.; Van, T.V.; Luong-Thanh, B.Y.; Tomlinson, M.; Fearon, P.; Ward, C.L.; Valdebenito, S.; Eisner, M.
    [This corrects the article Archives of Women's Mental Health.2021; 24(4): 619-625] Erratum for Prenatal attachment: using measurement invariance to test the validity of comparisons across eight culturally diverse countries
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    Prenatal attachment: using measurement invariance to test the validity of comparisons across eight culturally diverse countries
    (Springer, 2021) Foley, S.; Hughes, C.; Murray, A.L.; Baban, A.; Fernando, A.D.; Madrid, B.; Osafo, J.; Sikander, S.; Abbasi, F.; Walker, S.; Luong-Thanh, B.Y.; Bảo, Y.L.T.; Tomlinson, M.; Fearon, P.; Ward, C.L.; Valdebenito, S.; Eisner, M.
    ABSTRACT: Studies in high-income countries (HICs) have shown that variability in maternal-fetal attachment (MFA) predict important maternal health and child outcomes. However, the validity of MFA ratings in low- and middle-income countries (LMICs) remains unknown. Addressing this gap, we assessed measurement invariance to test the conceptual equivalence of the Prenatal Attachment Inventory (PAI: Muller, 1993) across eight LMICs. Our aim was to determine whether the PAI yields similar information from pregnant women across different cultural contexts. We administered the 18-item PAI to 1181 mothers in the third trimester (Mean age = 28.27 years old, SD = 5.81 years, range = 18-48 years) expecting their first infant (n = 359) or a later-born infant (n = 820) as part of a prospective birth cohort study involving eight middle-income countries: Ghana, Jamaica, Pakistan, Philippines, Romania, South Africa, Sri Lanka and Vietnam. We used Multiple Group Confirmatory Factor Analyses to assess across-site measurement invariance. A single latent factor with partial measurement invariance was found across all sites except Pakistan. Group comparisons showed that mean levels of MFA were lowest for expectant mothers in Vietnam and highest for expectant mothers in Sri Lanka. MFA was higher in first-time mothers than in mothers expecting a later-born child. The PAI yields similar information about MFA across culturally distinct middle-income countries. These findings strengthen confidence in the use of the tool across different settings; future studies should explore the use of the PAI as a screen for maternal behaviour that place children at risk. KEYWORDS: Cross-cultural; Lower-middle income; Maternal-fetal attachment; Measurement invariance; Parity; Pregnancy.
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    The role of maternal depression symptoms and maternal attachment in predicting exclusive breastfeeding: A multisite prospective study
    (Mary Ann Liebert, Inc., 2024) Costin, M.R.; Taut, D.; Baban, A.; Ionescu, T.; Murray, A.; Lindsay, C.; Secara, E.; Abbasi, F.; Acheampong, I.S.; Katus, L.; Thanh, Y.L.; Hernandez, S.C.L.S.; Randeny, S.; Toit, S.D.; Valdebenito, S.; Eisner, M.P.
    BACKGROUND: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. MATERIALS AND METHODS: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. RESULTS: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. CONCLUSIONS: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context.
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