PREGNANCY AND AUTOIMMUNE DISEASES: EXPLORING THE MOTHER’S MENTAL WORLD

Casula Fabiana;Lampis Jessica;Busonera Alessandra;Monni Giovanni;Cataudella Stefania

2018-01-01

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Abstract

Autoimmune disease mainly affects women in their reproductive years and has a significant impact on childbearing. Pregnancy can induce an improvement of the mother’s symptomatology in some kinf of diseases such as rheumatoid arthritis, while exacerbating or having no effect on other autoimmune diseases as sclerosys multiple (Borchers et al, 2010). This “uncertainty” can affect the process of psychological transformation and reorganization, which leads to the acquisition of a maternal identity sustained by a mental representation of the self as a mother and of the future baby, although he or she is still unborn (Ammaniti et al, 1999; RaphaelLeff, 2010). The quality of the mother-fetus emotional bond is considered particularly important for the subsequent attachment relationship and the psychological development of the infant (Ammaniti et al, 2013; Benoit et al, 1997). At the last thrimester of pregnancy 10 women with different autoimmune diseases (sclerosys multiple, lupus erythematosus, type 1 diabetes), and 10 nonrisk women were interviewed using the “Interview of Maternal Representations during Pregnancy-Revised Version” (IRMAG-R; Ammaniti & Tambelli, 2010). All interviews were audiotaped, transcribed verbatim, and analyzed by using qualitative content analysis in Atlas.ti. Two independent judges coded 5/20 interviews; agreement was >80%. The women with autoimmune disease, compared to nonrisk women, were more ambivalent toward pregnancy, were less able to recognize physical and psychological changes and to imagine the child. These are considered risk factors which could negatively affect the postnatal caregiving system (Van Bussel et al, 2009). These results focus on the importance of early multidisciplinary interventions that can support expectant women when they show signs of relationship difficulties with their infants prior to his/her birth.