Impact of a multiple, IVF birth on post-partum mental health: A composite analysis

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. © The Author 2007.