Introduction: It is well established that a premature birth increases the likelihood of developing anxiety during the postpartum period, and that the environment of the neonatal intensive care unit (NICU) might be a contributing factor. Mothers of earlier premature infants may experience these anxieties to a higher degree compared to mothers of later premature infants. The aim of this study was to explore the association between prematurity and postpartum-specific anxiety, and the relationship between postpartum-specific anxiety and stress in the NICU.Materials and methods: Mothers (N = 237) of infants aged between birth and 12 months completed an online survey containing the Postpartum Specific Anxiety Scale – Research Short Form (PSAS-RSF) and the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). Structural equation modeling was used to analyze the relationship between gestational age and postpartum-specific anxiety, with one-way ANOVAs used to analyze this relationship with respect to categories of gestational age. Hierarchical regression models analyzed the relationship between postpartum-specific anxiety and stress in the NICU.Results: For the PSAS-RSF, Practical Infant Care Anxieties (p = 0.001), Maternal Competence and Attachment Anxieties (p = 0.033), and Infant Safety and Welfare Anxieties (p = 0.020) were significantly associated with week of gestation. Practical Infant Care and Infant Safety and Welfare Anxieties were significantly higher for mothers of late premature infants, compared to mothers of term infants (p < 0.001; p = 0.019). There were no significant between-group differences with respect to Maternal Competence and Attachment Anxieties. After controlling for potential confounders, Infant Safety and Welfare Anxieties were significantly associated with increased stress in the NICU (p < 0.001) as measured by the PSS:NICU.Conclusions: Our findings highlight the need for interventions for mothers with premature infants, which specifically target anxieties reflected in the PSAS-RSF, such as routine care and increasing maternal self-efficacy.

Objective: Mothers of premature infants are more likely to develop anxiety during the first postpartum year than mothers of term infants. However, commonly used measures of anxiety were developed for general adult populations and may produce spurious, over-inflated scores when used in a postpartum context. Although perinatal-specific tools such as the Postpartum Specific Anxiety Scale [PSAS] offer a promising alternative form of measurement, it is not clear whether the measure performs similarly in mothers of premature infants as it does in mothers of term infants. The objective of the current study was to identify whether items on the Postpartum Specific Anxiety Scale - Research Short Form (PSAS-RSF) are being interpreted in the same manner in mothers of term infants and mothers of premature infants. Mothers (N = 320) participated in an international on-line survey between February 2022 and March 2023 (n = 160 mothers of premature infants, n = 160 mothers of term infants) where they completed the PSAS-RSF. Data were analysed using a measurement invariance analysis to assess whether constructs of the PSAS-RSF are performing in a similar manner across the two groups. Results: Whilst the PSAS-RSF achieved configural invariance and so retains its four-factor structure, metric invariance was not reached and so items are being interpreted differently in mothers of premature infants. Items concerning infant-separation, finance, and anxieties surrounding infant health are potentially problematic. Future research must now modify the PSAS-RSF for specific use in mothers of premature infants, to ensure measurement of anxiety in this population is valid.

Purpose: Whilst the antenatal period is well established as a period of increased vulnerability to mental health difficulties, restrictions resulting from COVID-19 lockdown in the UK are likely to have negatively affected psychosocial outcomes in these women. Materials and Methods: This study aimed to describe prevalence rates of clinically relevant antenatal anxiety and depression, and explore whether psychosocial changes as a result of the pandemic were predictive of clinically relevant anxiety and depression. Antenatal women (N = 684) completed an online survey of psychosocial measures during the UK government's initial lockdown restrictions. Results: Descriptive statistics indicate women experienced high levels of anxiety and depression and that changes resulting from restrictions were perceived negatively. Whilst 11.7% of women reported a current, clinical diagnosis of depression, 47.8% reported a score of ≥13 on the EPDS, indicating clinically relevant depression. Similarly, 18.7% of women reported a current, clinical diagnosis of anxiety, but 68.1% scored ≥40 on the STAI, indicating clinically relevant anxiety. After controlling for known demographic risk factors, only psychosocial change because of COVID-19 restrictions predicted clinically relevant anxiety (28%) and depression (27%). Conclusions: This study highlights the importance of considering antenatal women as a high-priority group, and ensuring antenatal care remains accessible and uninterrupted in any future crises.

Objectives: To describe the development and the methodology for validation of a new scale for postpartum anxiety for mothers of preterm infants, and a ‘Velcro’ sub‐scale of the Postpartum Specific Anxiety Scale for use with mothers who have had infants admitted to the Neonatal Intensive Care Unit. Methods: We undertook three forms of iterative psychometric development: (1) Patient and public involvement and engagement discussions with key clinical, academic, and lay stakeholders to understand the needs for modifying the Postpartum Specific Anxiety Scale—Research Short Form for use in this population; (2) Expert panel ratings with clinical and academic stakeholders; and (3) Cognitive interviews with mothers to ensure items were relevant, comprehensive, and understandable. Planned studies must ensure the psychometric properties of these two new scales. Results: Patient and Public Involvement and Engagement discussions identified clear avenues for modification of the PSAS‐RSF, but the need for an additional NICU‐specific scale was clear. Experts rated the new items highly on their relevance. Cognitive interviews further ensured that items were well understood and that meaning was being interpreted in the intended manner. Only minor changes to the scales were implemented after each change. Conclusions: This is the first study to describe the process of developing and the subsequent proposed validation of postpartum‐specific tools for use with mothers of preterm infants and those with infants in the Neonatal Intensive Care Unit. Clear avenues have been identified for the validation and implementation of both measures.

Background: Unplanned pregnancy is a public health issue and understanding women’s decision making aids practitioners in assessing fertility trends, contraception use, and family planning counselling. In Italy, Catholicism reinforces ‘natural reproduction’ and ‘traditional’ contraception, making it an ‘Imperfect Contraceptive Society.’ A valid and reliable measure of pregnancy intentionality is increasingly important, and the London Measure of Unplanned Pregnancy (LMUP) has proved effective. Objectives and Methods: This study comprised four stages: (1) English–Italian translation and back-translation to create the Italian version [LMUP-IT]; (2) online data collection from postnatal women; (3) evaluation of its psychometric properties (targeting, reliability, construct validity via CFA and measurement invariance with a UK sample, ‘known groups’ hypothesis testing); and (4) exploratory analysis of its associations with perinatal mental health. The sample comprised 450 postnatal women (M_age = 33.6 ± 4.5). Results: The LMUP-IT was shown to be reliable (ωT = 0.81, α = 0.76), with acceptable targeting. Measurement invariance testing confirmed consistency with the UK sample in factor structure, loadings, intercepts, and errors. LMUP-IT scores significantly correlated with well-known indicators of perinatal mental health. Conclusions: Overall, the LMUP-IT is a reliable measure of pregnancy intention in Italian for postpartum women. Understanding pregnancy intention will help healthcare professionals tailor interventions to better support women’s mental health during the transition to motherhood.