In my Prenatal and Infant Development class, I was required to conduct a literature review over an article related to infant development. In the future, as a Women's Health Nurse Practitioner, I hope to work with expectant mothers and apply the knowledge I have learned. I learned about prenatal care during the first year of life and its impact on the mother and infant. This information could be very applicable when it comes to working with expecting mothers.

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Article Review
Taylor Smith
Human Development and Family Science
HDFS 3900
Dr. Stephanie Whitten
September 28, 2022

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Article Citation: de Souza, V. C. A., Parlato-Oliveira, E., Anchieta, L. M., Machado, A. M. C.,
& Savelon, S. V. (2022). The effects of prenatal diagnosis on the interaction of the mother-infant
dyad: A longitudinal study of prenatal care in the first year of life. Frontiers in Psychology, 13,
Article e804724. https://doi.org/10.3389/fpsyg.2022.804724
Literature Review
The quality of interactions between a mother and child during the first few years of a
child’s life greatly impacts the cognitive and emotional development of the child (de Souza et al.,
2022). The objective of the current study was to determine how prenatal diagnosis of
malformation may impact the quality of early interactions between a mother and child. Previous
research represented the importance of the maternal representations during fetal development.
The expectations and maternal representations formed before the child is born can influence the
behaviors of the mother after birth (de Souza et al., 2022). The advancements in technology have
allowed for pregnant women to become aware of any malformations long before the birth. The
stage of pregnancy at which a mother discovers there is a malformation was questioned to
influence maternal representations that are formed after diagnosis.
One previous study found that pregnant women who had minor fetal malformations later
found that future children were at risk of negative consequences for mother-child early
interaction and emotional engagement development (de Souza et al., 2022). The previously
published works mentioned in the current study found that diagnosis and prognosis of the
malformed fetus impacts the mother’s family and social relationships, their perceptions about the
fetus and gestational period, as well as on their projections about childbirth and the future (de
Souza et al., 2022). Current research lacks information on how the timing of diagnosis during the
gestational period impacted maternal representations and mother-child interaction. The current

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study had two main limitations including the lack of participants to complete all phases of the
study, and the diversity of malformation diagnosis which made the study group non-homogenous
(de Souza et al., 2022). The current study worked to investigate the impact of prenatal diagnosis
of malformation on the quality of mother-child interactions, and how a structured follow-up can
influence the results.
Methods
A longitudinal observational study was conducted to study mother-child interactions from
the gestational stage until the child was twelve months of age. The study consisted of 250
pregnant women at first, but only 50 women participated in all stages of the study de Souza et
al., 2022). The study narrowed down the group to 50 women by only including pregnant women
who received a prenatal diagnosis of some type of malformation that compromise the
neurological, auditory, and visual development and pregnant women who were in the third
trimester with normal imaging tests (de Souza et al., 2022). To prevent any additional influential
factors, babies with any malformation that could impact brain development were excluded from
the study. The experimental group consisted of 25 women with fetuses with a prenatal diagnosis
of malformation, and the control group consisted of 25 women with fetuses without a prenatal
diagnosis of malformation. Anxiety and depressive state data were collected using the COVI and
Raskin Scales to determine how anxiety and depression throughout the gestational period could
impact maternal representations (de Souza et al., 2022). Mother-child interactions were recorded
at six different times throughout the study. The first recording was conducted when the child was
a newborn, and then recorded again every two months until the child was 12 months of age.
The video-recorded interactions consisted of three different activities lasting three
minutes each. Free interaction, mother-child interaction without any toys, Toy interaction,

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mother-child interaction including a puppy, and song interaction, mother child interaction while
the mother sang the “Happy Birthday” song were the three components being evaluated (de
Souza et al., 2022). Due to the current study being an observational study, the researcher did not
interfere in the study, resulting the use of explanatory and response variables only. The quality of
mother-child interactions was measured using the Coding Interacting Behavior classification
system. The Coding Interactive Behavior for newborns bases evaluations on the interactions such
as the direction of the mother’s gaze, mother’s touch, baby’s affection, and more (de Souza et al.,
2022). The Coding Interactive Behavior used from two months of age onward analyzed the
domains of maternal sensitivity, maternal intrusiveness, maternal limit setting, baby
involvement, withdrawal of the baby, baby resilience, dyadic reciprocity, and dyadic negative
states (de Souza et al., 2022).
Results – Discussion
The study supported the hypothesis. In the gestational phase, the results of the research
found significant differences between the control and experimental groups regarding scores in
anxiety and depressive symptoms (de Souza et al., 2022). There is a higher prevalence of
severity in the experimental group than compared to the control group. The results show that
there was no statistically significant difference between the control and experimental groups for
different types of maternal representations. In the postnatal phase, significant differences were
found between the two groups. The experimental groups presented higher levels of maternal
sensitivity at 6 months of age, of baby involvement at 9 to 12 months of age, and of dyadic
reciprocity at 6, 9, and 12 months of age (de Souza et al., 2022). The control group presented
higher values of withdrawal of the baby at 6 months and of dyadic negative states at 6 and 9
months of age (de Souza et al., 2022).

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Implications for Working with Infants and Toddlers
Regarding working with infants and toddlers, infants that have higher quality mother-
infant interactions may have stronger social skills than those who did not have high quality
mother-infant interactions. Strong ties between parents and their children portray a baby’s first
impression and exposure to intimate relationships. The way these relationships form and develop
between a mother and child can greatly impact an infant’s developmental outcomes. The family
is a child’s first source of developing intimate relationships, and the way those relationships are
viewed can impact how a child views relationships with others (de Souza et al., 2022).
Infants and toddlers who lack proper social support at birth face many adversities when
trying to develop proper relationships with others. People who work with children can benefit
from knowing this information by working to develop a strong sense of social support for the
children they work with. It is important for each child to feel a sense of connection and support
from others to avoid issues with self-esteem (d de Souza et al., 2022). Any caregiver of an infant
or toddler should know how important it is to give them the support and attention they need to
provide the best care possible.
Application to Future Profession
In the future, I plan to become a women’s health nurse practitioner. In this career, I
would work with pregnant women during their gestational periods. Using the information that I
have learned from my research; I would have many opportunities in the future to apply my
knowledge for the benefit of expecting mothers. It is critical for mothers to understand the
importance of early interactions to provide a solid foundation for their child’s overall
development. I would be able to help prepare mothers for creating high quality interactions with
their infant, and I would also have knowledge of structured coping methods for mothers who

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receive some form of fetal malformation diagnosis. There are a multitude of ways to incorporate
the information learned into my future profession, and I feel as if knowing this information
significantly benefits myself as well as any mother’s I will be working with in the future.