The psychological well-being and prenatal bonding of gestational surrogates.
The psychological well-being and prenatal bonding of gestational surrogates.
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DOI：
10.1093/humrep/dey048
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发表时间：
2018-02-23
期刊：
影响因子：
--
通讯作者：
Golombok S
中科院分区：
文献类型：
--
作者：
Lamba N;Jadva V;Kadam K;Golombok S
印度代孕妈妈的心理健康和产前联系与对照组的母亲有什么不同？与对照组母亲相比，代孕母亲在怀孕期间和出生后的抑郁程度更高，与未出生婴儿的情感联系更少，对胎儿的健康成长更关心。西方的研究发现，代孕者不会遭受长期的心理伤害。一项研究表明，与孕妇相比，代孕妈妈与胎儿的联系更少。本研究采用前瞻性、纵向和横断面设计。代孕者和一组匹配的孕妇在怀孕4-9个月和出生后4-6个月被观察了两次。采用半结构式访谈和标准化问卷，对孕期50名代孕母亲和69名准妈妈以及产后45名代孕母亲和49名准妈妈进行问卷调查。所有代孕者都在接待国际准父母的怀孕。与对照组的母亲相比，代孕母亲在怀孕期间和出生后的抑郁水平更高(P<；0.02)。孕期社会支持低、隐藏代孕和对他人的批评是代孕母亲产后抑郁程度较高的预测因素(P<；0.05)。在产前联系方面，与孕妇相比，代孕妈妈与胎儿的互动较少，对胎儿的考虑也较少，但采用了更好的饮食习惯，更有可能避免怀孕期间的不健康行为(P<；0.05)。在怀孕期间或戒酒后，未发现更大的产前联系与更大的心理痛苦之间的关联。所有代孕者都是从孟买的一家诊所招募的，因此该样本的代表性尚不清楚。此外，不能排除代孕者做出社会合意回应的可能性。由于这是对低收入国家代孕者心理幸福感的第一次研究，研究结果具有重要的政策意义。向代孕者提供支持和咨询，特别是在怀孕期间，可能会缓解代孕者面临的一些心理问题。这项研究得到了惠康信托[097857/Z/11/Z]和剑桥尼赫鲁信托的支持。K.K.是科里昂生育诊所的医学主任。所有其他作者都没有利益冲突要申报。
How does the psychological well-being and prenatal bonding of Indian surrogates differ from a comparison group of mothers? Surrogates had higher levels of depression during pregnancy and post-birth, displayed lower emotional connection with the unborn baby, and greater care towards the healthy growth of the foetus, than the comparison group of mothers. Studies in the West have found that surrogates do not suffer long-term psychological harm. One study has shown that surrogates bond less with the foetus than expectant mothers. This study uses a prospective, longitudinal and cross-sectional design. Surrogates and a matched group of expectant mothers were seen twice, during 4–9 months of pregnancy and 4–6 months after the birth. Semi-structured interviews and standardized questionnaires were administered to 50 surrogates and 69 expectant mothers during pregnancy and 45 surrogates and 49 expectant mothers post-birth. All gestational surrogates were hosting pregnancies for international intended parents. Surrogates had higher levels of depression compared to the comparison group of mothers, during pregnancy and post-birth (P < 0.02). Low social support during pregnancy, hiding surrogacy and criticism from others were found to be predictive of higher depression in surrogates post-birth (P < 0.05). Regarding prenatal bonding, surrogates interacted less with and thought less about the foetus but adopted better eating habits and were more likely to avoid unhealthy practices during pregnancy, than expectant mothers (P < 0.05). No associations were found between greater prenatal bonding and greater psychological distress during pregnancy or after relinquishment. All surrogates were recruited from one clinic in Mumbai, and thus the representativeness of this sample is not known. Also, the possibility of socially desirable responding from surrogates cannot be ruled out. As this is the first study of the psychological well-being of surrogates in low-income countries, the findings have important policy implications. Providing support and counselling to surrogates, especially during pregnancy, may alleviate some of the psychological problems faced by surrogates. This study was supported by the Wellcome Trust [097857/Z/11/Z] and Nehru Trust, Cambridge. K.K. is the Medical Director of Corion Fertility Clinic. All other authors have no conflict of interest to declare.
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