Adverse Birth Experiences and Parent Adjustment Associated With Atypical Genital Appearance Due to Differences of Sex Development.

Autor:	Traino KA; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Fisher RS; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Basile NL; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Dattilo TM; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Baskin LS; Department of Urology, University of California San Francisco Medical Center, USA., Buchanan CL; Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA., Chan YM; Division of Endocrinology, and Harvard Medical School, Boston Children's Hospital, USA., Cheng EY; Department of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, USA., Coplen DE; Division of Urologic Surgery, St. Louis Children's Hospital, USA., Kolon TF; Division of Urology, Children's Hospital of Philadelphia, USA., Lakshmanan Y; Department of Urology, Children's Hospital of Michigan, USA., Palmer BW; Department of Pediatric Urology, Cook Children's Medical Center, USA., Mullins LL; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Ciciolla LM; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA., Wisniewski AB; Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, USA.
Jazyk:	angličtina
Zdroj:	Journal of pediatric psychology [J Pediatr Psychol] 2023 Sep 20; Vol. 48 (9), pp. 759-767.
DOI:	10.1093/jpepsy/jsad042
Abstrakt:	Objective: Differences/disorders of sex development (DSDs) are rare, congenital conditions involving discordance between chromosomes, gonads, and phenotypic sex and are often diagnosed in infancy. A key subset of parents of children newly diagnosed with a DSD experience clinically elevated distress. The present study examines the relationship between perinatal factors (i.e., gestational age, delivery method) and trajectories of parental adjustment. Methods: Parent participants (mothers = 37; fathers = 27) completed measures at baseline, 6- and 12-month follow-up. Multilevel linear regression controlled for clustering of the data at three levels (i.e., time point, parent, and family) and examined the relationship between perinatal factors and trajectories of depressive and anxious symptoms. Two-way interactions between perinatal factors and parent type were evaluated. Results: Overall depressive and anxious symptoms decreased over time. There were significant interactions between gestational age and parent type for depressive and anxious symptoms, with younger gestational age having a stronger negative effect on mothers vs. fathers. There was a significant interaction between time and gestational age for depressive symptoms, with 36 weeks' gestational age demonstrating a higher overall trajectory of depressive symptoms across time compared to 38 and 40 weeks. Findings for the delivery method were not significant. Conclusions: Findings uniquely demonstrated younger gestational age was associated with increased depressive symptoms, particularly for mothers compared to fathers. Thus, a more premature birth may predispose parents of infants with DSD to distress. Psychosocial providers should contextualize early diagnosis-related discussions within stressful birth experiences when providing support. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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