Influence of gentle birth delivery procedures and other perinatal circumstances on infant temperament: developmental and social implications

Parity moderates the effect of delivery mode on maternal ratings of infant temperament

Objective

Cesarean section (CS) rates are rising rapidly around the world but no conclusive evidence has been obtained about the possible short- and long-term effects of CS on child behavior. We evaluated prospectively the association between CS and infant temperament across the first 9 postpartum months, controlling for indications for CS and investigating parity and infant sex as moderators.

Methods

The sample consisted of mothers and their healthy infants. Infant temperament was measured using the Infant Characteristics Questionnaire completed by the mothers at 6 weeks (n = 452) and 9 months (n = 258) postpartum. Mode of birth was classified into spontaneous vaginal birth (n = 347 for 6 weeks sample; 197 for 9 months sample), CS planned for medical reasons (n = 55; 28) and emergency CS (n = 50; 33).

Results

Multiple regression analysis revealed no main effects of birth mode, but showed a significant interaction between birth mode and parity indicating that emergency CS in firstborn infants was associated with more difficult temperament at 6 weeks. There were no significant associations between indications for CS and infant temperament, although breech presentation predicted difficult temperament at 9 months.

Conclusion

We largely failed to support the association between CS and infant temperament. Although our results suggest that emergency CS may be associated with temperament in firstborns, further research is needed to replicate this finding, preferably using observational measures to assess child temperament.

Relationships between parental ratings of infant temperament, risk status, and delivery method

One hundred forty parents rated the temperament of their infants between the ages of 4 and 8 months. Analyses of the data examined the relationships between temperament and infant risk status (high or low), delivery method (vaginal or cesarean section), and the combined effects of infant risk status and delivery method. Although high-risk and low-risk infants were similar on the easy-difficult profile ratings of the revised infant temperament questionnaire, high-risk infants were rated more adaptable and more positive in mood than were the low-risk infants. Low-risk infants delivered by cesarean section were rated less optimally on three of the temperament factor scores, including withdrawal, mood, and adaptability. Interpretations of these findings are discussed and suggestions are offered for nurse practitioners and their provision of pediatric care to infants and their families.

Trends in temperament research

The paper focuses on current concepts of temperament that has led to different approaches within the field of temperament research. The concept of temperament has interested scholars from ancient Greece until modern European and American research teams. Also in Soviet psychology temperament is getting attention. In Finland temperament research has advanced on two different lines. There is widespread agreement that temperament is a group of related traits and not just one trait attributed to the child. Controversy exists as to what extent temperament is an inborn characteristic of the child and to what extent temperament is born in the interactions between the child and his environment. Although there is controversy between structural and functional approaches, there is consensus of some points. First: temperament is generally regarded as a tendency existing over long periods of time rather than being visible in single behavioral acts. Second: temperament traits are genetically transmitted and this biological basis has been shown in several twin studies. Temperament concerns differences between individuals and not species-general characteristics. Temperament research has a tradition of putting emphasis on infancy. In adulthood temperament traits are more difficult to pin down. Pioneering researchers in the field, Chess and Thomas, have suggested that pure temperament traits might in adult personality be seen only in situations where new environmental challenges render former coping skills ineffective. Temperament research is still very scarce concerning adult personality though there are some studies about the role of affect in adult personality. Two basic temperament traits are generally accepted: activity level and emotionality, for the rest there are disagreements.(ABSTRACT TRUNCATED AT 250 WORDS)