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Sansone A. The central role of mindful parenting in child's emotional regulation and human flourishing: a blueprint perspective. Front Psychol 2024; 15:1420588. [PMID: 38988375 PMCID: PMC11233750 DOI: 10.3389/fpsyg.2024.1420588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
This article provides an innovative perspective of emotional-regulation and human flourishing which acknowledges the fundamental role of early parent-child experiences in shaping brain structure and functioning involved in emotional regulation and the central role of mindful parenting in facilitating emotional regulation in both parent and child (co-regulation). In this perspective paper the author underlines not only the central role of emotions and emotional regulation in human development and flourishing, but also the importance of maternal mental health, mindfulness, and a connected supportive community during pregnancy and postnatally in facilitating emotional regulation in both the caregiver and the infant and thus promoting secure attachment. The role of alloparenting and how we evolved to share childrearing is introduced, and emotional regulation is described not as an individual phenomenon but a relational embodied process. The associations between right brain functioning, mindfulness and secure attachment, all leading to emotional regulation, wellbeing, and resilience are described. Sharing findings and perspectives offer an opportunity for insights and reflection upon what strategies could be created to promote relational emotional regulation and wellbeing in early life, thus human flourishing leading to a peaceful society.
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Affiliation(s)
- Antonella Sansone
- Faculty of Society and Design, School of Psychology, Bond University, Robina, Gold Coast, QLD, Australia
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2
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Alptekin FB, Sucularlı E, Turgal E, Burhan HŞ, Güçlü O. Reducing the stress of mothers in the postpartum period: psychological inflexibility or mother-infant bonding. J Reprod Infant Psychol 2024:1-16. [PMID: 38899761 DOI: 10.1080/02646838.2024.2369578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Parental stress is a critical problem because it affects both the mental health of the mother and children's development. In addition to many factors related to birth and marriage, mother - infant bonding and psychological inflexibility are essential factors that can affect stress. In this study, we examined the effects of the psychological processes of mothers and factors related to pregnancy, mother, environment on parental stress, and their relationships. METHODS A sociodemographic variables scale, Acceptance and Action Questionnaire-II, Postpartum Bonding Questionnaire, and Parental Stress Scale were completed by 115 mothers in their first postpartum year. The model created with the correlation and regression results was subjected to path analysis. RESULTS Breastfeeding, psychological inflexibility, and mother - infant bonding are related to parental stress. The bonding problem is the mediator of the relationship between psychological inflexibility and parental stress. The entire effect of sleep quality on parental stress occurred through psychological inflexibility. CONCLUSION Efforts should be directed towards improving the bond between the mother and infant and enhancing the mother's psychological flexibility to lessen the negative impacts of stress. Breastfeeding should not be treated categorically, and its potential adverse effects should not be ignored.
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Affiliation(s)
| | - Eylül Sucularlı
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Ebru Turgal
- Faculty of Medicine, Department of Biostatistics, Ankara University, Ankara, Turkey
| | - Hüseyin Şehit Burhan
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Oya Güçlü
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
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3
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Thamby A, Bajaj A, L M, G SK, Gr G, K T, Ts J. Impaired mother-infant bonding: a community study from India. J Reprod Infant Psychol 2024; 42:528-539. [PMID: 36138562 DOI: 10.1080/02646838.2022.2125938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Impaired mother-infant bonding (MIB) is associated with inadequate maternal skills and pose a higher risk for impaired learning, child abuse, and psychiatric disorders in children. There are approximately 24 million births annually in India; however, community data on MIB from India is lacking. METHODS The study reports the findings of a cross-sectional survey of 8189 mothers with children of age between 13 and 15 months from the state of Kerala, India. Bonding was assessed using the Mother-infant bonding scale (MIBS). Other correlates assessed include obstetric and birth history, chronic pain, postpartum depression and temperamental issues in the infant. RESULTS The prevalence of impaired MIB in our sample was 12.3%. Those in extended/joint family, experiencing postpartum complications, supplementary breastfeeding in the first 6 months, postpartum depression and temperamental issues in infant were found to be associated with increased MIBS scores in a multivariate mixed-effect zero-inflated poisson model. CONCLUSION Experience of impaired MIB is not uncommon among mothers in India. More needs to be done to explore these issues, especially among those with higher risk to ensure appropriate interventions to mitigate long-term consequences.
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Affiliation(s)
- Abel Thamby
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Aakash Bajaj
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Manoj L
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Sunil Kumar G
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Gokul Gr
- National Health Mission (Kerala), Thiruvananthapuram, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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4
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Chang O, Huh K, Savoy CD, Krzeczkowski JE, Van Lieshout RJ. Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic. Dev Psychopathol 2024; 36:495-503. [PMID: 36700350 DOI: 10.1017/s0954579422001353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother-infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother-infant relationship. Maternal PPD was associated with more infant negative affectivity and mother-infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.
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Affiliation(s)
- Oswin Chang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - Kathryn Huh
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
| | - John E Krzeczkowski
- Department of Psychology, York University, 4700 Keele St, Toronto, ONM3J 1P3, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St W, Hamilton, ONL8S 4L8, Canada
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5
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Boekhorst MGBM, de Waal N, Smit L, Hulsbosch LP, van den Heuvel MI, Schwabe I, Pop V, Nyklíček I. A longitudinal study on the association between trait mindfulness and maternal bonding across the perinatal period. J Reprod Infant Psychol 2024:1-17. [PMID: 38655861 DOI: 10.1080/02646838.2024.2342904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024]
Abstract
AIMS/BACKGROUND The mother-to-infant is important for healthy child development. The current study focused on the association between maternal trait mindfulness and the course of maternal bonding from pregnancy to one year postpartum. DESIGN/METHODS Women participating in a prospective perinatal cohort study (n = 1003) completed online questionnaires on maternal bonding (Pre- and Post-natal Bonding Scale) at 28 weeks of pregnancy, and at 8 weeks, 6 months and 12 months postpartum. At 20 weeks of pregnancy, women completed the Three Facet Mindfulness Questionnaire - Short Form. Multilevel analyses were used to analyse 1) changes in maternal bonding over time and 2) the relationship of these changes with different facets of trait mindfulness measured once during pregnancy. Demographics, obstetrics, and depressive symptoms were controlled for. RESULTS Results showed that maternal bonding first increased from pregnancy to 8 weeks postpartum and then remained relatively stable throughout the first-year postpartum. On average, women with high scores on acting with awareness and non-judging also scored higher on maternal bonding, but demonstrated a smaller increase in maternal bonding scores over time when compared to women with medium and low scores on these mindfulness facets. Furthermore, non-reacting was also positively associated with the level of maternal bonding but was not related to the course of bonding over time. The main effects of non-reacting and non-judging were not significant after adjusting for covariates. Depressive symptoms and a high educational level were negatively associated with bonding. CONCLUSION Mindfulness-based interventions may be helpful in supporting expectant mothers who are at risk for suboptimal bonding.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Noor de Waal
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lisanne Smit
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lianne P Hulsbosch
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - Inga Schwabe
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
| | - Victor Pop
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Ivan Nyklíček
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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6
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Hagiwara K, Chen C, Okubo R, Okawa S, Nakagawa S, Tabuchi T. Identifying distinct subtypes of mother-to-infant bonding using latent profile analysis in a nationwide Japanese study. Arch Womens Ment Health 2024:10.1007/s00737-024-01467-9. [PMID: 38602553 DOI: 10.1007/s00737-024-01467-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/08/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Mother-to-infant bonding (MIB) is foundational for nurturing behaviors and an infant's development. Identifying risk factors for difficulties or problems in MIB is vital. However, traditional research often dichotomizes MIB using cutoff thresholds, overlooking its underlying complexities. This research utilizes latent profile analysis (LPA) to discern MIB subtypes in a nationwide Japanese dataset. METHODS We conducted LPA on data from the Mother-to-Infant Bonding Scale (MIBS), collected from 3,877 postpartum women within one year of childbirth. To empirically validate the derived profiles, we examined their associated risk factors, focusing on sociodemographic, health, and perinatal variables. RESULTS Four distinct MIB profiles emerged. Profile 1 indicated minimal difficulties, while Profile 4 exhibited severe multifaceted difficulties. Profiles 2 and 3 showed moderate difficulties distinguished by lack of positive affection and presence of negative affection (especially indifference), respectively. Compared to Profile 1, women in Profiles 2-4 had a higher likelihood of postpartum depression and low family support. Each profile also presented unique risk factors: medium family support in Profile 2, maternal working status in Profile 3, and pre-pregnancy underweight status in Profile 4. Notably, both Profiles 3 and 4 were also linked to increased feelings of loneliness since the onset of the COVID-19 pandemic. CONCLUSION This study represents the first application of LPA to MIB, revealing distinct subtypes and their respective risk profiles. These insights promise to enhance and personalize early interventions for difficulties in MIB, affirming the necessity of acknowledging MIB's heterogeneity.
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Affiliation(s)
- Kosuke Hagiwara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Fan X, Wu N, Tu Y, Zang T, Bai J, Peng G, Liu Y. Perinatal depression and infant and toddler neurodevelopment: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 159:105579. [PMID: 38342472 DOI: 10.1016/j.neubiorev.2024.105579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/13/2024]
Abstract
Many studies have focused on the effect of perinatal depression on neurodevelopment among children and adolescents. However, only a few studies have explored this relationship in infants and toddlers with inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between perinatal depression and infant and toddler neurodevelopment during the first two postnatal years. Twenty-three studies were included in this meta-analysis. Perinatal depression was associated with poorer cognitive (Cohen's d = -0.19, SE= 0.06, 95% CI = -0.30 to -0.08), language (Cohen's d = -0.24, SE = 0.09, 95% CI = -0.40 to -0.07), and motor (Cohen's d = -0.15, SE = 0.05, 95% CI = -0.26 to -0.05) development. Subgroup analyses showed that the types of maternal depression (prenatal depression vs. postnatal depression), the method of measuring maternal depression (rating scale vs. diagnostic interview), and the time interval between assessment of exposure and outcome had an impact on the observed effect about neurodevelopment of infants and toddlers. In addition, the results of our study pointed to a stronger significant association between prenatal depression and cognitive, language, and motor delays in infants and toddlers, whereas the association between postnatal depression and cognitive, language, and motor delays in infants and toddlers was not statistically significant. In conclusion, this study provided convincing evidence that the perinatal window is a sensitive period for offspring neurodevelopment.
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Affiliation(s)
- Xiaoxiao Fan
- Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China
| | - Ni Wu
- Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China
| | - Yiming Tu
- Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China
| | - Tianzi Zang
- Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA
| | - Ganggang Peng
- Shenzhen Second People's Hospital, Shenzhen 518000, China
| | - Yanqun Liu
- Wuhan University School of Nursing, Wuhan University, 169 Donghu Road, Wuhan 430071, China.
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8
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Chen C, Okawa S, Okubo R, Nakagawa S, Tabuchi T. Risk factors for persistent versus episodic mother-to-infant bonding difficulties in postpartum women in a nationwide Japanese longitudinal study. J Affect Disord 2024; 349:370-376. [PMID: 38199402 DOI: 10.1016/j.jad.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/21/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND The quality of mother-to-infant bonding (MIB) is a crucial determinant of nurturing behaviors and infant development, with bonding difficulties (MIBD) posing a substantial threat. While it is essential to identify MIBD risk factors, previous studies have generally examined MIBD at one time point, leaving the contributors to persistent MIBD uncertain. This study aims to discern longitudinal risk factors for persistent versus episodic MIBD. METHODS We evaluated 1833 postpartum Japanese women who delivered in the past twelve months, utilizing the Mother-to-Infant Bonding Scale (MIBS) and other sociodemographic, health, pregnancy, childbirth, and child-rearing related data (T1). Follow-up data were obtained six months later (T2). MIBD was defined as a MIBS score of five or more, with "persistent" and "episodic" MIBD classified based on its occurrence at both or either one of the time points, respectively. Logistic generalized estimating equations and inverse probability weighting were used to identify risk factors and address selective attribution bias. RESULTS Of the subjects, 15.8 % reported episodic and 11.3 % reported persistent MIBD. Shared risk factors for both conditions included postpartum depression and low levels of family support (OR = 1.501-6.343). However, pre-pregnancy underweight status (OR = 1.698) was a unique risk factor for episodic MIBD, while first-time motherhood, no or discontinuation of breastfeeding, and later postpartum months (OR = 1.540-3.179) were distinctive risk factors for persistent MIBD. CONCLUSION We identified both shared and unique risk factors for episodic and persistent MIBD. Particular attention should be afforded to persistent MIBD and early and proactive interventions to mitigate identified risk factors are recommended.
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Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Shebelsky R, Sadi W, Heesen P, Aber RN, Fein S, Iluz-Freundlich D, Shmueli A, Azem K, Radyan Tamayev I, Binyamin Y, Orbach-Zinger S. The relationship between postpartum pain and mother-infant bonding: A prospective observational study. Anaesth Crit Care Pain Med 2024; 43:101315. [PMID: 37865216 DOI: 10.1016/j.accpm.2023.101315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION Postpartum pain is associated with impaired maternal recovery and may influence mother-infant bonding. METHODS Participants who underwent a vaginal or cesarean delivery were assessed 24 h postpartum. Postpartum pain intensity was measured using the Verbal Numeric Score (VNS) (0-10) and classified as non-severe (<8) or severe pain (≥8). Maternal-infant bonding was evaluated using the Post-Partum Bonding Questionnaire (PBQ; 0-125), with a score > 5 defining impaired bonding. Demographic data included age, BMI, parity, education level, economic status, partnership, prior history of depression, familial history of depression, desire to breastfeed, epidural analgesia during labor, rooming in, and Edinburgh Postnatal Depression Scale (EPDS). Data were analyzed using 2 separate multivariable logistic regression models for vaginal and cesarean deliveries, where maximum postpartum pain was the independent variable and impaired postpartum bonding was the dependent variable and controlled for the other factors collected. RESULTS Severe postpartum pain (VNS ≥ 8) showed no significant relationship with impaired bonding when controlling for confounding variables. In vaginal deliveries, there was an association between a history of depression and impaired bonding (Odds Ratio 2.2 [1.07-4.65], p = 0.04) and EPDS > 10 and impaired bonding (OR 11.5 [3.2-73.6], p < 0.001). For cesarean deliveries, rooming in with the baby had a protective effect (OR 11.5 [3.2-73.6], p < 0.001). CONCLUSIONS Contrary to expectations, severe postpartum pain did not influence maternal-infant binding in the cohort of patients with vaginal and cesarean deliveries. Instead, factors such as maternal mental health and rooming-in practices appeared to exert more significant influence. CLINICAL TRIAL REGISTRATION NCT05206552.
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Affiliation(s)
- Rostislav Shebelsky
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Wadeea Sadi
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | | | - Rachel N Aber
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Shai Fein
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Iluz-Freundlich
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Anat Shmueli
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Karam Azem
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Inbar Radyan Tamayev
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Sharon Orbach-Zinger
- Department, Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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10
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Rusanen E, Lahikainen AR, Vierikko E, Pölkki P, Paavonen EJ. A Longitudinal Study of Maternal Postnatal Bonding and Psychosocial Factors that Contribute to Social-Emotional Development. Child Psychiatry Hum Dev 2024; 55:274-286. [PMID: 35870058 PMCID: PMC10796530 DOI: 10.1007/s10578-022-01398-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 05/23/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022]
Abstract
In this longitudinal study, we examined how maternal bonding and psycho-social factors are associated with social-emotional problems in two-year-old children. Our data came from a birth cohort from which data were collected at four timepoints: prenatally during the third trimester, and postnatally at 3, 8 and 24 months. The participants were 1,667 mothers, of which 943 (56.6%) returned the questionnaire at each timepoint of the longitudinal study. The Children's social-emotional problems were examined using the Brief Infant-Toddler Social and Emotional Assessment. According to linear regression analysis, maternal bonding difficulties at three and eight months, maternal expectations of the unborn baby during pregnancy, and maternal relationships within and outside the family were related to social-emotional problems in children of two years of age. The results highlight the importance of screening mothers who already prenatally have bonding problems or mothers who have bonding problems postnatally to provide effective and targeted intervention support.
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Affiliation(s)
- E Rusanen
- Faculty of Educational Sciences, University of Helsinki, P.O. Box 9, 00014, Helsinki, Finland.
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
| | - A R Lahikainen
- Faculty of Social Sciences, University of Tampere, FI-33014, Tampere, Finland
| | - E Vierikko
- Faculty of Social Sciences, Tampere University, FI-33014, Tampere, Finland
| | - P Pölkki
- Department of Social Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - E J Paavonen
- Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 400, 00029, HUS, Finland
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11
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Schiff DM, Muftu S, MacMillan KDL, Work EC, Hoeppner BB, Greenfield SF, Schwartz L, Chaiyachati B, Wilens TE, Bernstein JA. Mutual Mistrust: The Multilayered Experiences at the Intersection of Healthcare and Early Parenting Among Mothers With Opioid Use Disorder. J Addict Med 2024; 18:55-61. [PMID: 37994464 PMCID: PMC10872799 DOI: 10.1097/adm.0000000000001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVE The aim of the study is to explore the early parenting experiences among a cohort of postpartum individuals with opioid use disorder (OUD) both during and after the delivery hospitalization to identify areas of intervention to strengthen bonding and attachment. METHODS Semistructured qualitative interviews with recently pregnant people with OUD assessed parenting needs, supports, and goals in the context of the demands of addiction treatment and early motherhood. Probes explored the relationship between early parenting experiences, addiction, and recovery, as well as enabling factors and barriers to mother-infant bonding. Interviews were completed between 2019 to 2020. A constant comparative methods approach was used for codebook development and analysis. RESULTS Twenty-six women completed interviews a mean of 10.1 months postpartum. Twenty-four women were receiving methadone or buprenorphine treatment at delivery for OUD. Four interrelated themes emerged. Women experienced the following: (1) increased surveillance from healthcare workers who doubted their parenting ability; (2) a desire for a "normal" early parenting experience that was not disrupted by increased medical monitoring and surveillance; (3) complex and intersecting identities of being both a mother and a person in recovery; and (4) the importance of support from and advocacy by clinicians and peers to developing maternal confidence and connection. CONCLUSIONS Interventions are needed to improve the early parenting experiences of opioid-exposed mother-infant dyads, to address the mutual mistrust between health care providers and parents, and to provide additional supports to families. Promotion of positive attachment and parental self-efficacy should be prioritized over increased surveillance and scrutiny to sustain maternal recovery trajectories into early childhood and foster family well-being.
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Affiliation(s)
- Davida M. Schiff
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St Suite 860, Boston, Massachusetts, 02114
| | - Serra Muftu
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St Suite 860, Boston, Massachusetts, 02114
| | | | - Erin C. Work
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 125 Nashua St Suite 860, Boston, Massachusetts, 02114
| | - Bettina B. Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts, 02114
| | - Shelly F. Greenfield
- Division of Women’s Mental Health and Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill St, Belmont, MA 02478
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115
| | - Leah Schwartz
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115
| | - Barbara Chaiyachati
- Department of Pediatrics, Perelman School of Medicine, and Leonard Davis Institute, University of Pennsylvania
- Division of General Pediatrics, PolicyLab and Clinical Futures, Children’s Hospital of Philadelphia
| | - Timothy E. Wilens
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts, 02114
| | - Judith A. Bernstein
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
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12
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Pazzagli C, Buratta L, Coletti E, Mazzeschi C. Mother-to-infant bonding mediates the effects of depressive and anxious postpartum symptoms on parenting stress. J Psychosom Obstet Gynaecol 2023; 44:2264487. [PMID: 37837341 DOI: 10.1080/0167482x.2023.2264487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/24/2023] [Indexed: 10/16/2023] Open
Abstract
A number of studies have suggested close associations between maternal postpartum mental health (depressive and anxious symptoms), mother-infant bonding, and parenting stress. However, the relationship between maternal bonding and parenting stresshas hardly been explored in published literature. This cross-sectional study explored whether maternal bonding could mediate the effect of postpartum maternal mental health on parenting stress. This study assessed maternal bonding (MPAS), depressive and anxious symptoms (EPDS; STAI), and parenting stress (PSI) at 3 months postpartum in a community sample of 105 women (M (SD) = 32.60 (4.18) years old). Spearman's correlation analyses showed moderate to high correlations between these factors. The three mediation models run showed that mother's MPAS partially mitigates the effects of EPDS (b = 0.71; SE = 0.217; 95% CI = 0.290/1.136) and STAI State (b = 0.39; SE = 0.113; 95% CI = 0.178/0.625) on PSI, and totally mediated the relationship between STAI Trait and PSI (b = 0.59; SE = 0.155; 95% CI = 0.303/0.912). Maternal bonding resulted to be a relevant factor in the association between maternal mental health and parenting stress. This highlights the importance of interventions focusing on mother-infant relationship to reduce parenting stress and prevent developmental difficulties in children.
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Affiliation(s)
- Chiara Pazzagli
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Elena Coletti
- Department of Dynamic and Clinical Psychology, and Health Studies - Faculty of Medicine and Psychology, Sapienza University of Rome, Roma, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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13
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Toivo J, Tulivuo N, Kanzaki M, Koivisto AM, Kylmä J, Paavilainen E. First-Time Parents' Bonding with Their Baby: A Longitudinal Study on Finnish Parents during the First Eight Months of Parenthood. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1806. [PMID: 38002897 PMCID: PMC10670067 DOI: 10.3390/children10111806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019-2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1-2 months (T2) and 6-8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood.
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Affiliation(s)
- Jessica Toivo
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Noora Tulivuo
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Mitsuko Kanzaki
- Faculty of Nursing, Kyoto Tachibana University, Kyoto 607-8175, Japan;
| | - Anna-Maija Koivisto
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Kalevantie 4, 33014 Tampere, Finland;
| | - Jari Kylmä
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
| | - Eija Paavilainen
- Unit of Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland; (J.T.); (N.T.)
- Etelä-Pohjanmaa Welfare County, 60220 Seinäjoki, Finland
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14
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Yang G, Hisada A, Yamamoto M, Kawanami A, Mori C, Sakurai K. Effect of nausea and vomiting during pregnancy on mother-to-infant bonding and the mediation effect of postpartum depression: the Japan Environment and Children's Study. BMC Pregnancy Childbirth 2023; 23:704. [PMID: 37784021 PMCID: PMC10544486 DOI: 10.1186/s12884-023-06014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Mother-to-infant bonding (MIB) is critical for the health and well-being of the mother and child. Furthermore, MIB has been shown to boost the social-emotional development of infants, while also giving mothers a sense of happiness in raising their children. Nausea and vomiting during pregnancy (NVP) is a normal complication of pregnancy, occurring in approximately 50-90% of pregnant women in the early stages of pregnancy. Despite widespread knowledge of MIB and postpartum depression, little research attention has been given to the effects of NVP on MIB. This study aimed to investigate the relationship between NVP and MIB and the mediating effects of postpartum depression. METHODS We analyzed the data of 88,424 infants and 87,658 mothers from the Japan Environment and Children's Study (JECS), which is a government-funded nationwide birth prospective cohort study. The Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) was used to assess MIB, and the Edinburgh Postpartum Depression Scale (EPDS) was utilized to assess postpartum depression. We divided participants into four groups according to a self-reported questionnaire assessing NVP (No NVP, Mild NVP, Moderate NVP, and Severe NVP). MIB disorder was defined as a MIBS-J score ≥ 5. Logistic analysis was performed to evaluate the effect of NVP on MIB disorder at one year after delivery. A mediation analysis was conducted to examine whether postpartum depression mediated the association between NVP and MIBS-J scores. RESULTS The logistic regression analysis results revealed reduced risks of MIB disorder among mothers with Moderate NVP (adjusted OR 0.93; 95% confidence interval, 0.86-0.99) and Severe NVP (adjusted OR 0.81; 95% confidence interval, 0.74-0.89), compared to those with No NVP. The mediation analysis revealed that NVP positively correlated with MIBS-J score in the indirect effect via postpartum depression, while NVP (Mild NVP, Moderate NVP, and Severe NVP) negatively correlated with MIBS-J score in the direct effect. CONCLUSION The risks of MIB disorder were reduced in the Moderate NVP and Severe NVP mothers, although NVP inhibited the development of MIB via postpartum depression. The development of effective interventions for postpartum depression is important to improve MIB among mothers with NVP.
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Affiliation(s)
- Gui Yang
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Aya Hisada
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Akiko Kawanami
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inageku, Chiba, Japan.
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15
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Abbasoglu A, Varnali H, Tekindal MA, Pala HG. Being a Mother under the COVID-19 Pandemic Lockdown: Evaluation of Perinatal Anxiety, Prenatal Attachment, and Maternal-Infant Attachment. Am J Perinatol 2023; 40:1602-1610. [PMID: 35750316 DOI: 10.1055/a-1884-1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The novel coronavirus disease 2019 (COVID-19) pandemic has caused both physical and emotional stress throughout the population due to its worldwide impact. The unknowns about the disease, social isolation, pregnant women's concerns regarding exposure to the COVID-19, inaccessibility to necessary care, and the possibility of harm to their fetus may cause increased psychological distress during the perinatal period. We aimed to evaluate the association between perinatal anxiety, prenatal attachment, and maternal-infant attachment status among women with those who delivered their child in a tertiary-care center with rigid hospital restrictions. STUDY DESIGN Term pregnant women who experienced the last trimester of their pregnancy during COVID-19 curfews between December 2020 and May 2021 were asked specifically about their concerns during the COVID-19 pandemic and they filled out the Perinatal Anxiety Screening Scale (PASS) and the Prenatal Attachment Inventory (PAI). Those who continued the follow-up within a month of period following the delivery were invited to fill out the Maternal Attachment Inventory (MAI). RESULTS A total of 600 women completed the survey. While the evaluation of the relationship between participants' mean PAI and MAI scores showed a statistically significant positive correlation between scales (r = 0.124, p = 0.002), mean PAI and PASS scores showed a statistically significant negative correlation between scale scores (r = - 0.137, p = 0.001). CONCLUSION Examining the factors, affecting the attachment process of pregnant and puerperal women, will guide the improvement of the quality of health services in the COVID-19 pandemic. KEY POINTS · COVID-19 caused psychological distress, with increased anxiety among perinatal women.. · Elevated levels of anxiety about COVID-19 during pregnancy may lead to insecure attachment.. · Insecure attachment in the prenatal period will negatively contribute to mother - infant attachment..
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Affiliation(s)
- Aslihan Abbasoglu
- Department of Neonatology, Faculty of Medicine, İzmir Katip Celebi University, Balatcik Mahallesi, Turkey
| | - Hayriye Varnali
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Konak/İzmir, Turkey
| | - Mustafa A Tekindal
- Department of Biostatistics, Faculty of Medicine, İzmir Katip Celebi University, İzmir, Turkey
| | - Halil G Pala
- Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Konak/İzmir, Turkey
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16
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Laifer LM, DiLillo D, Brock RL. Prenatal negative affectivity and trauma-related distress predict mindful parenting during toddler age: Examining parent-infant bonding as a mechanism. Dev Psychopathol 2023; 35:1036-1050. [PMID: 34649640 DOI: 10.1017/s0954579421000894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Despite findings demonstrating the importance of parental present-centered awareness, factors undermining mindful parenting have received less attention. Increasingly, evidence points to parental psychopathology as a salient risk factor for parenting difficulties. Thus, the goal of the present study was to investigate specific dimensions of parental trauma-related distress and general negative affectivity during pregnancy as predictors of mindful parenting during toddler age. Parental psychopathology, parent-infant bonding, and mindful parenting were assessed in a sample of heterosexual couples (N = 159) across four waves of data collection spanning pregnancy to child age two. Data were analyzed using path analysis within a dyadic framework. Results demonstrated the unique impact of maternal trauma-related distress during pregnancy (e.g., intrusions and avoidance) on facets of mindful parenting more than two years later. Further, among both mothers and fathers, general negative affectivity common across internalizing disorders undermined mindful parenting through impaired parent-infant bonding. Findings highlight the need for early intervention efforts that incorporate mindfulness strategies to reduce subthreshold symptoms of prenatal psychopathology, promote healthy bonding, and improve parental awareness and self-regulation, thereby enhancing the overall parent-child relationship.
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17
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de Waal N, Boekhorst MGBM, Nyklíček I, Pop VJM. Maternal-infant bonding and partner support during pregnancy and postpartum: Associations with early child social-emotional development. Infant Behav Dev 2023; 72:101871. [PMID: 37544195 DOI: 10.1016/j.infbeh.2023.101871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
The first 1000 days after conception are considered critical for healthy development and well-being throughout life. Fundamental to health practices during pregnancy and positive parenting after birth is the development of maternal-infant bonding. Previous research has demonstrated the importance of having an involved partner during pregnancy and in parenting for optimal maternal-infant bonding. The current study examined maternal-infant bonding and partner support during pregnancy and the postpartum period, and their associations with early child social-emotional development. A total of 227 women completed the Pre- and Postnatal Bonding Scale (PPBS) and Tilburg Pregnancy Distress Scale (TPDS) during pregnancy (32 weeks of gestation) and at 8 months postpartum, assessing maternal-infant bonding and partner support. Additionally, a questionnaire on social-emotional behavior of the Bayley Scales of Infant and Toddler Development was administered to mothers to measure child development at 2 years of age. Path analyses revealed an indirect positive effect of prenatal maternal-infant bonding on child social-emotional development through postnatal maternal-infant bonding, as well as mediating effects of pre- and postnatal maternal-infant bonding on the association between pre- and postnatal partner support and child social-emotional development. Our findings support the notion that an emotional connection from mother to child originates in pregnancy and that experiencing positive feelings towards the fetus promotes positive maternal-infant bonding after birth and social-emotional capacities of the child. Additionally, having a supportive partner during pregnancy and postpartum, might be essential for the development of optimal maternal-infant bonding.
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Affiliation(s)
- Noor de Waal
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Myrthe G B M Boekhorst
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Ivan Nyklíček
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Victor J M Pop
- Center of Research on Psychological disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
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18
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Gürkan KP, Bektaş İ, Yücedağ M, Yılmaz Ö. Simulation for breastfeeding support during the COVID-19 pandemic in Turkey: A quasi-experimental study. Health Care Women Int 2023; 44:968-985. [PMID: 36943200 DOI: 10.1080/07399332.2023.2172410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 03/23/2023]
Abstract
We aimed to investigate the effect of simulation-supported breastfeeding program given to women in pregnancy during the COVID-19 pandemic period on breastfeeding success, breastfeeding self-efficacy, and mother-infant attachment. They carried out this study 73 pregnant women who presented to the obstetrics and gynecology clinic of a hospital and were selected by using the simple random sampling method. The researchers used a quasi-experimental design in this study. After the simulation-supported breastfeeding program, they found that breastfeeding success and breastfeeding self-efficacy were increased in the experimental group compared to the control group. The researchers were used the structural equation model, regression analysis, and independent samples t-test in the data analysis. The education given to pregnant women in this period when social interaction decreases becomes more important. Researchers are recommended that breastfeeding education should start in the antenatal period and continue in the postpartum period by using different education methods together. Simulation-supported breastfeeding program is a model that can be used to provide breastfeeding education for pregnant women in public health emergencies such as the COVID-19 pandemic. With this program, the number of visits to the hospital for breastfeeding education will decrease, and more remote counseling will be provided.
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Affiliation(s)
- Kübra Pınar Gürkan
- Faculty of Nursing, Public Health Nursing Department, Dokuz Eylül University, Izmir, Turkey
| | - İlknur Bektaş
- Health Science Faculty, Child Health and Illness Nursıng Department, Bakırçay University, Izmir, Turkey
| | - Mehtap Yücedağ
- Kartal Lütfi Kırdar City Hospital, Gynecology and Obstetrics Clinic, İstanbul, Turkey
| | - Özgür Yılmaz
- Manisa City Hospital, Gynecology and Obstetrics Clinic, Manisa, Turkey
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19
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Volling BL, Tan L, Rosenberg L, Bader LR. Will I love my second baby as much as my first? Prevalence and psychosocial correlates of maternal-fetal relationship anxiety for second-time mothers. Infant Ment Health J 2023; 44:541-553. [PMID: 37149744 PMCID: PMC10524320 DOI: 10.1002/imhj.22060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
Most mothers have more than one child. Second-time mothers may worry about whether they will love the second baby as much as their first child. The current study examined mothers' maternal-fetal relationship anxiety (MFRA) to their second baby, the prediction of mother-infant bonding (MIB) and infant-mother attachment security post-partum, and the psychosocial correlates of mothers' MFRA during pregnancy. Mothers (N = 241, 85.9% White, 5.4% Black, 2.9% Asian/American, 3.7% Latina) and their second-born infants (55% boys) living in the Midwestern United States participated in a longitudinal investigation starting in the last trimester of pregnancy, and 1, 4, 8, and 12 months postpartum. Most women reported little to no anxiety about forming an attachment to their second baby (89.1%). MFRA predicted less maternal warmth toward the baby at 1, 4, and 8 months postpartum, but did not predict security of the infant-mother attachment at 12 months. Prenatal MFRA was also related to maternal depressive symptoms, an insecure attachment with the first child, more marital distress, and more adult attachment avoidance and ambivalence prenatally. Mothers worrying about loving a second baby as much as their first child may be experiencing other psychosocial risks that have repercussions for the developing mother-infant relationship.
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Affiliation(s)
| | - Lin Tan
- Department of Health Behavior and Health Systems, University of North Texas, Health Science Center
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20
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Murakami K, Noda A, Ishikuro M, Obara T, Ueno F, Onuma T, Matsuzaki F, Kikuchi S, Kobayashi N, Hamada H, Iwama N, Metoki H, Kikuya M, Saito M, Sugawara J, Tomita H, Yaegashi N, Kuriyama S. Maternal postnatal bonding disorder and developmental delays in children: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Arch Womens Ment Health 2023; 26:219-226. [PMID: 36809368 DOI: 10.1007/s00737-023-01298-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
Although there is some evidence regarding an association between maternal bonding disorder and child development, studies have mainly focused on development during the period of infancy. We aimed to examine the associations between maternal postnatal bonding disorder and developmental delays in children beyond 2 years of age. We analyzed data from 8380 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Maternal bonding disorder was defined as Mother-to-Infant Bonding Scale score of ≥5 at 1 month after delivery. The Ages & Stages Questionnaires, Third Edition, which consists of five developmental areas, was used to assess developmental delays in children at 2 and 3.5 years of age. Multiple logistic regression analyses were conducted to examine the associations between postnatal bonding disorder and developmental delays after adjustment for age, education, income, parity, feelings toward pregnancy, postnatal depressive symptoms, child's sex, preterm birth, and birth defects. Bonding disorder was associated with developmental delays in children at 2 and 3.5 years of age: the odds ratios (95% confidence intervals) were 1.55 (1.32-1.83) and 1.60 (1.34-1.90), respectively. Bonding disorder was associated with delay in communication only at 3.5 years of age. Bonding disorder was associated with delay in gross motor, fine motor, and problem solving, but not delay in the personal-social domain, at 2 and 3.5 years of age. In conclusion, maternal bonding disorder 1 month after delivery was associated with an increased risk of developmental delays in children beyond 2 years of age.
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Affiliation(s)
- Keiko Murakami
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Aoi Noda
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Fumihiko Ueno
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Fumiko Matsuzaki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Saya Kikuchi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Natsuko Kobayashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Noriyuki Iwama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Junichi Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
- International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
- International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan
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21
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Laifer LM, Maras OR, Sáez G, Gervais SJ, Brock RL. Self-objectification during the perinatal period: The role of body surveillance in maternal and infant wellbeing. RESEARCH SQUARE 2023:rs.3.rs-2714781. [PMID: 36993503 PMCID: PMC10055659 DOI: 10.21203/rs.3.rs-2714781/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Pregnancy represents a unique time during which women's bodies undergo significant physical changes (e.g., expanding belly, larger breasts, weight gain) that can elicit increased objectification. Experiences of objectification set the stage for women to view themselves as sexual objects (i.e., self-objectification) and is associated with adverse mental health outcomes. Although women may experience heightened self-objectification and behavioral consequences (such as body surveillance) due to the objectification of pregnant bodies in Western cultures, there are remarkably few studies examining objectification theory among women during the perinatal period. The present study investigated the impact of body surveillance, a consequence of self-objectification, on maternal mental health, mother-infant bonding, and infant socioemotional outcomes in a sample of 159 women navigating pregnancy and postpartum. Utilizing a serial mediation model, we found that mothers who endorsed higher levels of body surveillance during pregnancy reported more depressive symptoms and body dissatisfaction, which were associated with greater impairments in mother-infant bonding following childbirth and more infant socioemotional dysfunction at 1-year postpartum. Maternal prenatal depressive symptoms emerged as a unique mechanism through which body surveillance predicted bonding impairments and subsequent infant outcomes. Results highlight the critical need for early intervention efforts that not only target general depression, but also promote body functionality and acceptance over the Western "thin ideal" of attractiveness among expecting mothers.
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Horowitz-Kraus T, Gashri C. Multimodal Approach for Characterizing the Quality of Parent-Child Interaction: A Single Synchronization Source May Not Tell the Whole Story. BIOLOGY 2023; 12:biology12020241. [PMID: 36829518 PMCID: PMC9952901 DOI: 10.3390/biology12020241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
The interaction between the parent and child is essential for the child's cognitive and emotional development and sets the path for future well-being. These interactions, starting from birth, are necessary for providing the sensory stimulation the child needs in the critical time window of brain development. The characterization of parent-child interactions is traditionally performed by human decoding. This approach is considered the leading and most accurate way of characterizing the quality of these interactions. However, the development of computational tools and especially the concept of parent-child synchronization opened up an additional source of data characterizing these interactions in an objective, less human-labor manner. Such sources include brain-to-brain, voice/speech, eye contact, motor, and heart-rate synchronization. However, can a single source synchronization dataset accurately represent parent-child interaction? Will attending to the same stimulation, often resulting in a higher brain-to-brain synchronization, be considered an interactive condition? In this perspective, we will try to convey a new concept of the child-parent interaction synchronization (CHIPS) matrix, which includes the different sources of signals generated during an interaction. Such a model may assist in explaining the source of interaction alterations in the case of child/parent developmental/emotional or sensory deficits and may open up new ways of assessing interventions and changes in parent-child interactions along development. We will discuss this interaction during one of the parent-child joint activities providing opportunities for interaction, i.e., storytelling.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Technion, Haifa 3200003, Israel
- Faculty of Biomedical Engineering, Technion, Haifa 3200003, Israel
- Neuropsychology Department, Kennedy Krieger Institute, Baltimore, MD 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Correspondence: ; Tel.: +972-522-989298
| | - Carmel Gashri
- Faculty of Biomedical Engineering, Technion, Haifa 3200003, Israel
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23
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Babore A, Trumello C, Lombardi L, Candelori C, Chirumbolo A, Cattelino E, Baiocco R, Bramanti SM, Viceconti ML, Pignataro S, Morelli M. Mothers' and Children's Mental Health During the COVID-19 Pandemic Lockdown: The Mediating Role of Parenting Stress. Child Psychiatry Hum Dev 2023; 54:134-146. [PMID: 34417927 PMCID: PMC8379586 DOI: 10.1007/s10578-021-01230-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 01/26/2023]
Abstract
The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children's depression and mothers' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers' parenting stress on the relationship between mothers' individual distress and children's depression was also explored. Finally, the study analyzed whether children's biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers' individual distress and parenting stress and children's depression were higher than those recorded for the normative samples. Mothers' parenting stress was found to mediate the association between mothers' individual distress and children's depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children's depression.
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Affiliation(s)
- Alessandra Babore
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Carmen Trumello
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Lucia Lombardi
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Carla Candelori
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Antonio Chirumbolo
- grid.7841.aDepartment of Psychology, Sapienza University of Rome, Rome, Italy
| | - Elena Cattelino
- Department of Human and Social Sciences, University of Valle d’Aosta, Aosta, Italy
| | - Roberto Baiocco
- grid.7841.aDepartment of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sonia Monique Bramanti
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Maria Luisa Viceconti
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Silvia Pignataro
- grid.412451.70000 0001 2181 4941Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Mara Morelli
- grid.7841.aDepartment of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Borges Rubin B, Puchalski Trettim J, Coelho Scholl C, Teixeira Coelho F, Freire Puccinelli E, Bonati de Matos M, Ghisleni G, Tavares Pinheiro R, de Avila Quevedo L. Maternal-fetal attachment and social-emotional development in infants at 3 months of age: A population-based study in southern Brazil. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2022. [DOI: 10.5964/ijpr.6693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Studies relate Maternal-Fetal Attachment (MFA) to delays in child development, however, the relationship with the social-emotional development is still unclear. Thus, the aim of this study was to investigate the association between MFA and social-emotional development in infants at 3 months old, in a population-based sample in southern Brazil. This was a follow-up study corresponding to second and third wave of a population-based cohort study with pregnant women who were living in Pelotas (Southern Brazil). Social-emotional development was assessed using the Bayley Scales of Infant Development - Third Edition (BSID-III) and MFA was measured with the Maternal-Fetal Attachment Scale (MFAS). The sample consisted of 702 mother-infant dyads. In the adjusted analysis, MFA was a predictor of social-emotional development, even when controlled for sociodemographic, maternal mental health and infant characteristics. Thus, with each increase to one point in the MFA score, there was an increase of β = 0.14, 95% CI [0.05, 0.23] in the social-emotional development score. These findings highlight the importance of MFA in early child development. Thus, infants with positive experiences of affection since the gestational period will be able to develop positive social and emotional health.
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Bohne A, Nordahl D, Høifødt RS, Moe V, Landsem IP, Wang CEA, Pfuhl G. Do parental cognitions during pregnancy predict bonding after birth in a low-risk sample? Front Psychol 2022; 13:986757. [DOI: 10.3389/fpsyg.2022.986757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Parental bonding to their infant is important for healthy parent-infant interaction and infant development. Characteristics in the parents affect how they bond to their newborn. Parental cognitions such as repetitive negative thinking, a thinking style associated with mental health issues, and cognitive dispositions, e.g., mood-congruent attentional bias or negative implicit attitudes to infants, might affect bonding.To assess the influence of cognitive factors on bonding, 350 participants (220 pregnant women and their partners) were recruited over two years by midwives at the hospital and in the communal health care services. Participants were followed throughout the pregnancy and until the infant was seven months old as a part of the Northern Babies Longitudinal Study. Both mothers and fathers took part. First, we measured demographics, repetitive negative thinking, attentional bias, and implicit attitudes to infants during pregnancy, as predictors of bonding two months postnatally. Second, we also measured infant regulatory problems, and depressive symptoms at two months postnatally as predictors of parents’ perception of infant temperament at five months. Robust regression analyses were performed to test hypotheses.Results showed that mothers and fathers differed on several variables. Parity was beneficial for bonding in mothers but not for fathers. Higher levels of mothers’ repetitive negative thinking during pregnancy predicted weaker bonding, which was a non-significant trend in fathers. For fathers, higher education predicted weaker bonding, but not for mothers. Mothers’ perception of their infant temperament at five months was significantly affected by bonding at two months, but for fathers, their depressive symptoms were the only significant predictor of perceived infant temperament.In conclusion, for mothers, their relationship with their infant is essential for how they experience their infant, while for fathers their own wellbeing might be the most important factor. Health care providers should screen parents’ thoughts and emotions already during pregnancy to help facilitate optimal bonding.
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26
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Gonzales AM, Tejero LMS. Concept analysis of maternal-infant attachment during the weaning process. BELITUNG NURSING JOURNAL 2022; 8:381-388. [PMID: 37554495 PMCID: PMC10405663 DOI: 10.33546/bnj.2178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 08/13/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND At the time that the mother and baby transit from breastfeeding to weaning, maternal-fetal attachment becomes a crucial basis for maintaining their emotional relationship. Conceptualization is needed to better understand the phenomenon of maternal-infant attachment during the weaning process. OBJECTIVE The purpose of this paper is to explore and identify the essence of the term maternal-infant attachment during weaning and to arrive at an operational definition of the concept. METHOD Concept analysis following Walker and Avant. RESULTS The attributes of maternal-infant attachment during the weaning process include (1) consistent and properly timed, (2) dynamic transactional interaction, and (3) secured adjustment. Maternal-infant attachment during the weaning process is brought by maternal sensitivity, closeness and proximity seeking, gentle and positive weaning, and breastfeeding experiences, which later turn into favorable emotion regulation, maturity, self-efficacy, secured bond, less intrusive interaction, resilience, and child's behavioral and development. CONCLUSION This concept analysis provides new insight into maternal-infant attachment during the weaning process that guides the nursing practice. Also, the findings can help develop or improve the models, theories, and instruments collected for maintaining maternal-fetal attachment during the weaning process.
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Affiliation(s)
- Artemio M. Gonzales
- College of Nursing, University of the Philippines Manila, Manila, Philippines
- College of Arts, Sciences, and Technology, Occidental Mindoro State College, San Jose, Occidental Mindoro, Philippines
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27
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Xia H, Zhu X, Zhu C. Associations between pro-inflammatory cytokines and fatigue in pregnant women. PeerJ 2022; 10:e13965. [PMID: 36193420 PMCID: PMC9526404 DOI: 10.7717/peerj.13965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/08/2022] [Indexed: 01/19/2023] Open
Abstract
Background Fatigue is one of the most prevalent symptoms among pregnant women. In patients with various diseases, pro-inflammatory cytokines are associated with fatigue; however, such associations are unknown in pregnant women. Objectives The objective of this study was to examine the associations between pro-inflammatory cytokines and prenatal fatigue. Methods A cross-sectional study was conducted on 271 pregnant Chinese women in their third trimester of pregnancy. Patient-reported Outcome Measurement Information System (PROMIS) was used to evaluate women's prenatal fatigue. Using enzyme-linked immunosorbent assay (ELISA), the serum concentrations of four pro-inflammatory cytokines, including tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6) and interleukin 8 (IL-8), were measured. The data was analyzed by correlation analysis and general linear regression analysis. Results In this sample, the mean (standard deviation) of fatigue scores was 51.94 (10.79). TNF-α (r = 0.21, p < 0.001), IL-6 (r = 0.134, p = 0.027) and IL-8 (r = 0.209, p = 0.001) were positively correlated to prenatal fatigue, although IL-1β was not. TNF-α (β = 0.263, p < 0.001), along with sleep quality (β = 0.27, p < 0.001) and depression (β = 0.376, p < 0.001) independently predicted prenatal fatigue. Conclusions TNF-α was identified as an independent biomarker for prenatal fatigue in our study. Reducing pro-inflammatory cytokines may be a unique method for lowering prenatal fatigue and, consequently, enhancing mother and child health.
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Affiliation(s)
- Haiou Xia
- School of Nursing, Fudan University, Shanghai, China
| | - Xiaoxiao Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Chunxiang Zhu
- Obstetrical Ward, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
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28
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Hruschak JL, Palopoli AC, Thomason ME, Trentacosta CJ. Maternal-fetal attachment, parenting stress during infancy, and child outcomes at age 3 years. Infant Ment Health J 2022; 43:681-694. [PMID: 35962730 PMCID: PMC9580238 DOI: 10.1002/imhj.22004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/04/2022] [Indexed: 11/07/2022]
Abstract
Maternal-fetal attachment (MFA), a woman's relationship with and affiliative behaviors toward her unborn child, has been linked to near-term infant physical and developmental outcomes. However, further longitudinal research is needed to understand whether the impact of MFA extends past the earliest years of life. The current study explored relationships between MFA and child socioemotional competence and behavior problems at age 3 and whether parenting stress mediated the association between MFA and child outcomes. Data were collected from 221 primarily Black/African-American mothers who completed a scale of MFA during pregnancy. Mothers reported on parenting stress at infant age 7 months and reported on child socioemotional competence and problem behaviors at child age 3 years. In path analyses, MFA was directly associated with child socioemotional competence at age 3 years, but an indirect association between MFA and socioemotional competence via parenting stress was not significant. We also observed a significant indirect association between lower MFA and child internalizing behavior problems via parenting stress that was related to maternal dissatisfaction regarding interactions with her child. Findings suggest that assessing MFA may serve as a means to identify dyads who would benefit from support to promote individual health outcomes.
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Affiliation(s)
- Jessica L Hruschak
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Ava C Palopoli
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Moriah E Thomason
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
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29
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Olhaberry MP, León MJ, Coo S, Barrientos M, Pérez JC. An explanatory model of parental sensitivity in the mother-father-infant triad. Infant Ment Health J 2022; 43:714-729. [PMID: 35921446 DOI: 10.1002/imhj.22007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 04/20/2022] [Indexed: 11/09/2022]
Abstract
Quality of early family interactions has been associated with child development, bonding, and mental health. Childhood adversity, stress, and depression impact parenting, affecting the quality of the interaction within the mother-father-child triad. The aim of the present study was to analyze the influence of parents' adverse childhood experiences, depressive symptoms, and parental stress, on their sensitive response toward their tooddler and quality of traidic interactions. A correlational cross-sectional method was used. The sample included 80 mother-father-child triads, of toddlers with social-emotional difficulties. Parents early adverse experiences, parental stress, and depressive symptoms were assessed through self-report measures. Observational measures on parental sensitivity and triadic interaction were used. For mothers and fathers, adverse childhood experiences were associated with depressive symptoms in adulthood. Sensitivity toward their child and stress were positively associated among both parents. Symptoms of depression in mothers were associated with lower sensitivity toward their child, but in fathers, their sensitive response was influenced by the level of parental stress in the mother. In both parents, greater sensitivity in the dyadic interaction with the child was associated with a higher quality of the triadic interactions, in the triad as a whole, and in the regulation and involvement of the child.
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Affiliation(s)
- Marcia Paola Olhaberry
- Department of Psychology, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile
| | - María José León
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile
| | - Soledad Coo
- Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
| | | | - J Carola Pérez
- Millennium Institute for Research on Depression and Personality (MIDAP), Santiago, Chile.,Facultad de Psicología, Universidad del Desarrollo (UDD), Santiago, Chile
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Do Improvements in Maternal Mental Health Predict Improvements in Parenting? Mechanisms of the Mindful with Your Baby Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137571. [PMID: 35805226 PMCID: PMC9265470 DOI: 10.3390/ijerph19137571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/16/2022] [Accepted: 06/18/2022] [Indexed: 02/01/2023]
Abstract
Postpartum mental health symptoms are associated with parenting difficulties, which have negative consequences for child development. Interventions for young mothers should target their mental health problems and parenting difficulties. Mindful with Your Baby (MwyB) is an intervention for parents, with a baby, who experience (mental) health problems and/or stress or insecurity in parenting. This study seeks to replicate previous effects of MwyB regarding mindfulness, mindful parenting, maternal (mental) health (psychological distress, depressive mood, physical health complaints) and parenting outcomes (parenting stress, parental self-efficacy, bonding), and gain insight into the working mechanisms of the training. Mothers with babies aged 1–18 months (n = 61) completed questionnaires at waitlist, pretest, posttest, and 8-week follow-up. No significant differences were seen between the waitlist and pretest. Significant improvements in all outcomes were shown in the posttest (except for physical health complaints) and follow-up, compared to the pretest. Improvements in depressive symptoms and physical health complaints were dependent on improvements in mindfulness. Improvements in parental self-efficacy were dependent on improvements in mindful parenting. Improvements in some (mental) health and parenting outcomes seemed to be bidirectional. The results suggest that both mindfulness and mindful parenting are important for mothers who experience psychological distress and/or stress or insecurity in parenting their babies.
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Le Bas G, Youssef G, Macdonald JA, Teague S, Mattick R, Honan I, McIntosh JE, Khor S, Rossen L, Elliott EJ, Allsop S, Burns L, Olsson CA, Hutchinson D. The Role of Antenatal and Postnatal Maternal Bonding in Infant Development. J Am Acad Child Adolesc Psychiatry 2022; 61:820-829.e1. [PMID: 34555489 DOI: 10.1016/j.jaac.2021.08.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 08/09/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The affectional bond experienced by a mother toward her developing fetus/infant has been theorized to be a critical factor in determining infant developmental outcomes; yet there remains a paucity of research in this area, and a lack of high-quality longitudinal studies. This study aimed to examine the extent to which mother-to-infant bonding predicted infant development in a multi-wave longitudinal pregnancy cohort study (N = 1,347). METHOD Self-reported bonding was assessed using the Maternal Antenatal Attachment Scale at each trimester, and the Maternal Postnatal Attachment Scale at 8 weeks and 12 months postpartum. Infant development was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 12 months. RESULTS Bonding predicted indicators of infant social-affective development, including social-emotional, behavioral, and temperamental outcomes. Effect sizes ranged from small to moderate, increasing over the perinatal period (β = 0.11-0.27). Very small effects were also identified in the relationship between bonding and cognitive, language, and motor development (β = 0.06-0.08). CONCLUSION Findings suggest that a mother's perceived emotional connection with her child plays a role in predicting social-affective outcomes; prediction may not extend to other domains of infant development. Maternal bonding may therefore be a potentially modifiable predictor of infant social-affective outcomes, offering important considerations for preventive intervention.
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Affiliation(s)
- Genevieve Le Bas
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - George Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Jacqui A Macdonald
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Samantha Teague
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ingrid Honan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Jennifer E McIntosh
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia; The Bouverie Centre, La Trobe University, Bundoora, Australia
| | - Sarah Khor
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Larissa Rossen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; The British Columbia Children's Hospital Research Institute, The University of British Columbia, Canada
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia; The Sydney Children's Hospitals Network at Westmead, Sydney, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Craig A Olsson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Delyse Hutchinson
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Royal Children's Hospital, Melbourne, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
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Westerneng M, de Jonge A, van Baar AL, Witteveen AB, Jellema P, Paarlberg KM, Rijnders M, van der Horst HE. The effect of offering a third-trimester routine ultrasound on pregnancy-specific anxiety and mother-to-infant bonding in low-risk women: A pragmatic cluster-randomized controlled trial. Birth 2022; 49:61-70. [PMID: 34288070 PMCID: PMC9290476 DOI: 10.1111/birt.12573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Third-trimester routine ultrasounds are increasingly offered to monitor fetal growth. In addition to limited evidence for its clinical effectiveness, little is known about its importance for pregnancy-specific anxiety and mother-to-infant bonding. METHODS 1275 low-risk women participated in a Dutch nationwide pragmatic cluster-randomized trial and answered questionnaires on pregnancy-specific anxiety (PRAQ-R) and prenatal mother-to-infant bonding (MAAS) before and after a third-trimester routine ultrasound was offered to the intervention group. Linear mixed model regression analyses were performed to examine the effect of offering a third-trimester routine ultrasound on pregnancy-specific anxiety and mother-to-infant bonding. In addition, we examined whether the effect depended on maternal background characteristics and level of satisfaction with the ultrasound procedure. RESULTS We found no effect of offering a third-trimester routine ultrasound on pregnancy-specific anxiety and mother-to-infant bonding. However, interaction analyses showed that women with high levels of depressive symptoms at baseline and women who were very satisfied with the ultrasound procedure benefited somewhat more from offering a third-trimester routine ultrasound in terms of mother-to-infant bonding compared with women with low or no depressive symptoms, or less satisfied women. CONCLUSIONS The relationship between offering a third-trimester routine ultrasound with pregnancy-specific anxiety and mother-to-infant bonding is limited. A beneficial effect only applies to some subgroups of women. This implies that, in terms of psychological outcomes, there are no counterarguments to implementing a third-trimester routine ultrasound. Strong evidence for offering all pregnant women a third-trimester routine ultrasound for psychological reasons, however, is lacking.
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Affiliation(s)
- Myrte Westerneng
- Midwifery ScienceAVAGAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ank de Jonge
- Midwifery ScienceAVAGAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Anke B. Witteveen
- Midwifery ScienceAVAGAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Petra Jellema
- Midwifery ScienceAVAGAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | | | - Henriëtte E. van der Horst
- Department of General Practice and Elderly Care MedicineAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Sechi C, Prino LE, Rollé L, Lucarelli L, Vismara L. Maternal Attachment Representations during Pregnancy, Perinatal Maternal Depression, and Parenting Stress: Relations to Child's Attachment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:69. [PMID: 35010329 PMCID: PMC8751134 DOI: 10.3390/ijerph19010069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND This paper aimed to explore the associations between maternal representations of attachment evaluated during pregnancy, pre and postnatal maternal depression, parenting stress and child's attachment at 15 months after childbirth. METHODS Mothers (n = 71), and their infants participated in a longitudinal study of maternal attachment, pre and postnatal depression, parenting stress and child attachment. Adult Attachment Interview (AAI) was conducted between 24 and 26 weeks of pregnancy (Time 1), depression was assessed using the Edinburgh Perinatal Depression Scale (EPDS) (at Time 1 and 6 months after childbirth, i.e., Time 2), parenting stress was assessed using the Parenting Stress Index-Short Form (PS-SF) (at Time 2) and the Strange Situation Procedure (SSP) at child's 15 months of age (Time 3). RESULTS Free-autonomous maternal classification of attachment increases the likelihood of secure child classification in her offspring, while decreases that of avoidance and ambivalence. Insecure maternal representation of attachment evaluated during pregnancy and higher levels of parenting stress at six months after childbirth was associated with higher rates of infant insecure attachment at 15 months. CONCLUSIONS Our study validates the importance of considering maternal representations of attachment crucial in determining the quality of the caregiving environment, thereby the healthy development of children, despite the presence of other contextual risk.
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Affiliation(s)
- Cristina Sechi
- Department of Education, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (C.S.); (L.L.)
| | - Laura Elvira Prino
- Department of Philosophy and Education Sciences, University of Torino, 10124 Torino, Italy;
| | - Luca Rollé
- Department of Psychology, University of Torino, 10124 Torino, Italy;
| | - Loredana Lucarelli
- Department of Education, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (C.S.); (L.L.)
| | - Laura Vismara
- Department of Education, Psychology, Philosophy, University of Cagliari, 09123 Cagliari, Italy; (C.S.); (L.L.)
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Michałek-Kwiecień J, Kaźmierczak M, Karasiewicz K. Closeness with a partner and parental bond with a child during the transition to parenthood. Midwifery 2021; 105:103209. [PMID: 34890879 DOI: 10.1016/j.midw.2021.103209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/17/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this longitudinal study was to examine the dyadic interdependence of the relationships between partners' perception of closeness with one another and their pre- and postnatal bonds with a child. RESEARCH DESIGN AND PARTICIPANTS A total of 213 first-time expectant couples participated in the study both during pregnancy (1st stage) and after the child's birth (2nd stage). MEASUREMENTS The participants completed the following measures: the one-item pictorial Inclusion of Other into the Self (IOS) scale and the brief maternal and paternal versions of the Antenatal Attachment Scales (MAAS/PAAS, respectively) and Postnatal Attachment Scales (MPAS/PPAS, respectively). FINDINGS The Actor-Partner Interdependence Models (APIM) for distinguishable dyads were performed and revealed the positive effect of parents' perceptions of closeness with their partners regarding both their own and their partners' bond with their child during pregnancy. However, after the child's birth, for both mothers and fathers, only their own perception of closeness with their partners was associated with their bond with their child. Moreover, only the actor effects of bonding with a child during pregnancy as well as the change in perception of closeness with a partner on the partner's bond with their child after birth were found (no partner effect). KEY CONCLUSIONS Couple attributes during the transition to parenthood should be emphasized to promote the development of parental pre- and postnatal bonds.
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Cataudella S, Lampis J, Busonera A, Congia F, Melis GB, Zavattini GC. From pregnancy to 3 months after birth:the beginning of mother-infant relationship from a maternal perspective. J Reprod Infant Psychol 2021; 40:266-287. [PMID: 34693840 DOI: 10.1080/02646838.2021.1995597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND An early positive mother-child relationship is a central factor in the development of a psychologically balanced personality. The study aims to identify risk and protective factors for the development of a balanced maternal-infant postnatal attachment. We explored the association between maternal-infant attachment and prenatal and postnatal variables potentially implicated in the development of this early bond: maternal-foetal prenatal attachment, social support, memories of parental care, romantic attachment, dyadic adjustment, parity, breastfeeding, planning pregnancy, woman's and infant's age, and difficulty of delivery. METHODS 123 pregnant women participated in the longitudinal study; they were assessed on the MAAS, PBI, ECR-R, MSPSS (t1: pregnancy), MPAS (t2: 3-months postnatally), DAS , and CES-D (t1, t2). RESULTS Four significant predictors of maternal-infant postnatal attachment (MPAS) emerged: maternal-foetal prenatal attachment (β = 0.379, p < .001), anxiety in the romantic relationships (β=-0.237, p=0.019), prenatal and postnatal dyadic adjustment (t1, β=-0.323, p=0.025 ;t2, β=0.329, p=0.014) in the couple's relationship. These variables explained 20.2% of variance in mother-infant attachment (R2adjusted=0.202). DISCUSSION The study highlights associations of maternal-infant postnatal attachment with prenatal and postnatal relational variables and with other variables related to the woman's reproductive and pregnancy history. Clinical attention to these factors could help protect the well-being of mother and child.
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Affiliation(s)
- Stefania Cataudella
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Jessica Lampis
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Alessandra Busonera
- Department of Dynamic and Clinical Psychology, Sapienza, University of Rome, Italy
| | - Francesca Congia
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
| | - Gian Benedetto Melis
- Department of Obstetrics and Gynecology, University Hospital of Cagliari (AOUCA), Cagliari, Italy
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Ramsdell EL, Brock RL. Interparental Relationship Quality During Pregnancy: Implications for Early Parent-Infant Bonding and Infant Socioemotional Development. FAMILY PROCESS 2021; 60:966-983. [PMID: 32985686 DOI: 10.1111/famp.12599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Research demonstrates the central role of mother-child relationships in child socioemotional development; however, families are complex systems and the unique roles of multiple family subsystems in early infant development have received less attention. In the present study, we investigated the role of multiple family relationships (interparental, mother-infant, father-infant), during pregnancy and the first month after childbirth, in infant socioemotional functioning at 6 months. We administered semi-structured interviews during pregnancy to assess multiple qualities of the interparental relationship. At 1 month postpartum, parents completed reports about their feelings and attitudes toward their infant to assess impaired bonding. At 6 months, parents provided reports of child socioemotional functioning. Both mother-infant and father-infant impaired bonding were uniquely associated with infant socioemotional impairment, controlling for prenatal interparental relationship quality. Additionally, multiple dimensions of the interparental relationship (i.e., poor-quality conflict management, inadequate support for fathers, and low levels of respect toward mothers) were associated with infant socioemotional impairment controlling for parent-infant bonding. Results also demonstrated an indirect pathway, such that poor sexual quality during pregnancy was associated with fathers (but not mothers) reporting more impaired bonding with their infants, which was linked to greater infant socioemotional impairment. Results highlight the importance of understanding the broad family environment, prior to and immediately following the birth of the child, to identify at-risk children at the earliest possible stages of intervention.
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Affiliation(s)
- Erin L Ramsdell
- Department of Psychology, The University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Rebecca L Brock
- Department of Psychology, The University of Nebraska-Lincoln, Lincoln, NE, USA
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Fernandes DV, Canavarro MC, Moreira H. The role of mothers' self-compassion on mother-infant bonding during the COVID-19 pandemic: A longitudinal study exploring the mediating role of mindful parenting and parenting stress in the postpartum period. Infant Ment Health J 2021; 42:621-635. [PMID: 34407224 PMCID: PMC8426800 DOI: 10.1002/imhj.21942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/18/2021] [Indexed: 01/02/2023]
Abstract
The current COVID‐19 pandemic is a challenging time for postpartum mothers, and associated challenges may have a negative impact on their parenting and, consequently, on mother–infant bonding. This study aimed to longitudinally explore whether mothers’ self‐compassion was associated with mother–infant bonding and whether this relationship was mediated by mindful parenting and parenting stress. A total of 125 Portuguese mothers of infants aged between 0 and 12 months completed an online survey at two assessment points during the first wave of the COVID‐19 pandemic (T1: April–May 2020; T2: June–July 2020). The survey included several questionnaires assessing sociodemographic, clinical, and COVID‐19 information; self‐compassion; mindful parenting; parenting stress; and mother–infant bonding. Mothers presented significantly higher levels of self‐compassion, less impaired mother–infant bonding, and lower levels of depressive symptoms at T2 than T1. Higher levels of self‐compassion at T1 predicted less impaired mother–infant bonding at T2, and this relationship was mediated by higher levels of mindful parenting and lower levels of parenting stress (both assessed at T1). These results highlight the relevance of mothers’ self‐compassion to establishing mother–infant bonding in the postpartum period, particularly during the COVID‐19 pandemic, and the important role of mindful parenting and parenting stress in determining this relationship.
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Affiliation(s)
- Daniela V Fernandes
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria C Canavarro
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Helena Moreira
- Centre for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Schaber R, Kopp M, Zähringer A, Mack JT, Kress V, Garthus-Niegel S. Paternal Leave and Father-Infant Bonding: Findings From the Population-Based Cohort Study DREAM. Front Psychol 2021; 12:668028. [PMID: 34149562 PMCID: PMC8212974 DOI: 10.3389/fpsyg.2021.668028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Father-infant bonding is important for child development. Yet, in contrast to mother-infant bonding, little is known about factors that might facilitate father-infant bonding. With new generations of fathers being more involved in childcare, this study aims to examine the impact of paternal leave duration on father-infant bonding, and whether this relation is mediated by the amount of time fathers actively spend on childcare. Methods: Data of n = 637 fathers were derived from the German population-based cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Mediation analyses were conducted. Duration of paternal leave (predictor), weekly hours spent on childcare (mediator), and father-infant bonding (outcome) were measured at 14 months postpartum. The potential confounders current status of paternal leave, part-time work during paternal leave, duration of solo paternal leave, age, education, and partnership satisfaction were included in a second mediation analysis. Results: Without considering confounders, duration of paternal leave positively predicted father-infant bonding through weekly hours spent on childcare. When adding confounders to the model, this indirect path did not stay significant. Moreover, in the adjusted model and on the direct path duration of paternal leave negatively predicted father-infant bonding. Additionally, partnership satisfaction positively predicted father-infant bonding. Some study variables were significantly associated with the mediator. Longer duration of paternal leave, currently being on paternal leave, younger age, and lower educational level predicted more weekly hours spent on childcare. Conclusions: Duration of paternal leave not being a stable predictor for father-infant bonding suggests that fathers, who do not have the opportunity to take long periods of paternal leave, can still form strong bonds with their infants. Other factors, for example partnership satisfaction, which might represent fathers' underlying capacity to bond, might be more crucial for father-infant bonding. At the same time, results should not be interpreted in a way that father involvement (e.g., paternal leave/time spent) does not matter for children's development. The finding that longer duration of paternal leave increases weekly hours spent on childcare supports the idea that facilitating father involvement can be achieved by paternal leave incentives such as non-transferable father months.
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Affiliation(s)
- Ronja Schaber
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anna Zähringer
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Judith T Mack
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Victoria Kress
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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Tichelman E, Warmink-Perdijk W, Henrichs J, Peters L, Schellevis FG, Berger MY, Burger H. Intrapartum synthetic oxytocin, behavioral and emotional problems in children, and the role of postnatal depressive symptoms, postnatal anxiety and mother-to-infant bonding: A Dutch prospective cohort study. Midwifery 2021; 100:103045. [PMID: 34077815 DOI: 10.1016/j.midw.2021.103045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/22/2021] [Accepted: 05/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the association between intrapartum synthetic oxytocin and child behavioral and emotional problems and to assess if maternal depressive or anxious symptoms or mother-to-infant bonding play a mediating role in this association. DESIGN Prospective cohort study. SETTING Population-based Pregnancy Anxiety and Depression Study. PARTICIPANTS Pregnant women in their first trimester of pregnancy visiting a total of 109 primary and nine secondary obstetric care centers in the Netherlands between 2010 and 2014 were invited to participate. Follow-up measures used for the present study were collected from May 2010 to January 2019. Women with multiple gestations and with a preterm birth were excluded. MEASUREMENTS Intrapartum synthetic oxytocin exposure status was based on medical birth records and was defined as its administration (Yes/No), either for labour induction or augmentation. Child behavioral and emotional problems were measured with the Child Behavior Checklist at up to 60 months postpartum. Maternal depressive symptoms, anxiety and mother-to infant bonding were measured with the Edinburgh Postnatal Depression Scale, State Trait Anxiety Inventory and the Mother-to-Infant Bonding Scale from 6 months postpartum. We used multivariable linear regression models to estimate standardized beta coefficients and unique variance explained. FINDINGS 1,528 women responded. In total 607 women received intrapartum synthetic oxytocin. Intrapartum synthetic oxytocin administration was not associated with child behavioral and emotional problems, mother-to-infant bonding nor with postnatal anxiety. Intrapartum synthetic oxytocin was however significantly but weakly associated with more postnatal depressive symptoms (β=0.17, 95%CI of 0.03 to 0.30) explaining 0.6% of unique variance. Maternal postnatal depressive symptoms, postnatal anxiety symptoms and suboptimal mother-to-infant bonding were positively associated with child behavioral and emotional problems. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE We found no evidence that intrapartum synthetic oxytocin is associated with child behavioral and emotional problems, mother-to-infant bonding, or with postnatal anxiety symptoms. Because there was no association between intrapartum synthetic oxytocin and behavioral and emotional problems in children no mediation analysis was carried out. However, intrapartum synthetic oxytocin was positively but weakly associated with postnatal depressive symptoms. The clinical relevance of this finding is negligible in the general population, but unknown in a population with a high risk of depression.
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Affiliation(s)
- Elke Tichelman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public, Health research institute, Amsterdam, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care Medicine, the Netherlands.
| | - Willemijn Warmink-Perdijk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public, Health research institute, Amsterdam, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care Medicine, the Netherlands
| | - Jens Henrichs
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public, Health research institute, Amsterdam, the Netherlands
| | - Lillian Peters
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG, Amsterdam Public, Health research institute, Amsterdam, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care Medicine, the Netherlands
| | - Francois G Schellevis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Marjolein Y Berger
- University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care Medicine, the Netherlands
| | - Huibert Burger
- University of Groningen, University Medical Centre Groningen, Department of General Practice and Elderly Care Medicine, the Netherlands
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Etowa J, Hannan J, Etowa EB, Babatunde S, Phillips JC. Determinants of infant feeding practices among Black mothers living with HIV: a multinomial logistic regression analysis. BMC Public Health 2021; 21:663. [PMID: 33827510 PMCID: PMC8025335 DOI: 10.1186/s12889-021-10675-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infant feeding practices are imperative for babies' and mothers' health and emotional wellbeing. Although infant feeding may seem simple, the decisions surrounding it are complex and have far-reaching implications for women globally. This is an especially difficult concern among mothers living with HIV because breastfeeding can transmit HIV from mother to child. This is further complicated by cultural expectations in case of Black mothers living with HIV. This paper discusses determinants of infant feeding practices among Black mothers living with HIV who were on anti-retroviral therapy (ART) in two North American cites and one African city. METHODS A cross-sectional, multi-country survey using venue-based convenience sampling of Black mothers living with HIV was employed. The effective response rates were 89% (n = 89) in Ottawa, Canada; 67% (n = 201) in Miami, Florida, US; and 100% (n = 400) in Port Harcourt, Nigeria, equaling a total sample size of 690. Data were collected in Qualtrics and managed in Excel and SPSS. Multinomial logistic regression analyses were used to determine the factors influencing the mothers' infant feeding practices (Exclusive Formula Feeding [EFF] = 1; Mixed Feeding [MF] = 2; and Exclusive Breastfeeding [EBF while on ART] =3). RESULTS The results highlight socio-demographics, EFF determinants, and EBF determinants. The statistically significant determinants of infant feeding practices included national guideline on infant feeding, cultural beliefs and practices, healthcare systems, healthcare personnel, infant feeding attitudes, social support, and perceived stress. Mothers' mean ages were Ottawa (36.6 ± 6.4), Miami (32.4 ± 5.8), and Port Harcourt (34.7 ± 5.7). All sampled women gave birth to least one infant after their HIV diagnoses. Statistically significant (p < .05) determinants of EFF relative to MF were the national guideline of EFF (relative risk [RR] = 218.19), cultural beliefs (RR = .15), received healthcare (RR = 21.17), received healthcare through a nurse/midwife (RR = 3.1), and perceived stress (RR = .9). Statistically significant determinants of EBF relative to MF were received healthcare (RR = 20.26), received healthcare through a nurse/midwife (RR = 2.31), functional social support (RR = 1.07), and perceived stress (RR = .9). CONCLUSION While cultural beliefs and perceived stress favoured MF over EFF, advice of healthcare workers, and the care received from a nurse/midwife improved EFF over MF. Also while the mothers' perceived stress favoured MF over EBF, advice of their nurses or midwife and the social support improved EBF over MF. The providers advice was congruent with WHO and national guidelines for infant feeding among mothers living with HIV. These results have implications for nursing, healthcare practice, and policies on infant feeding practices for mothers living with HIV.
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Affiliation(s)
- Josephine Etowa
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Jean Hannan
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11200 Southwest 8th Street, Miami, FL, 33199, USA
| | - Egbe B Etowa
- Department of Sociology, Anthropology & Criminology; Faculty of Arts, Humanities & Social Sciences, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada.
| | - Seye Babatunde
- Centre for Health and Development, University of Port Harcourt, Port Harcourt, Nigeria
| | - J Craig Phillips
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
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Abstract
Although maternal postpartum mental health has been extensively studied, rather little is known regarding the factors that may facilitate psychological growth following childbirth. The present study set forth to examine various pre-birth, birth, and post-birth correlates of overall psychological growth and growth domains in postpartum women, assessed within the first months following childbirth. A sample of 428 women completed self-report measures pertaining to psychological growth, mental health, maternal attachment, and childbirth characteristics. We found that the majority of women reported psychological growth following childbirth, with those experiencing stressors in childbirth reporting the highest levels of appreciation for life. In regression analyses, postpartum factors were significantly associated with overall growth and growth domains, taking into account other factors. The more the childbirth was perceived as central to the mothers' identity and the better the maternal attachment was to the child, the higher levels of growth. Growth was also negatively related to endorsement of childbirth PTSD. Background factors, such as maternal age, education, and prior mental health, were associated with specific growth domains, although the association was small and there was no association with overall growth. Post-birth factors are important in ensuing psychological growth in the first months following birth. Attention to opportunities of growth following childbirth is warranted in clinical care, in particular following traumatic childbirth.
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Trombetta T, Giordano M, Santoniccolo F, Vismara L, Della Vedova AM, Rollè L. Pre-natal Attachment and Parent-To-Infant Attachment: A Systematic Review. Front Psychol 2021; 12:620942. [PMID: 33815204 PMCID: PMC8011495 DOI: 10.3389/fpsyg.2021.620942] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022] Open
Abstract
During the perinatal period, the establishment of the attachment relationship with the fetus and subsequently with the real child is crucial for the parents' and the child's well-being. Coherently with the assumption that the attachment relationship starts to develop during pregnancy, this systematic review aims to analyze and systematize studies focused on the association between pre-natal attachment and parent-to-infant attachment, in order to clarify the emerging results and provide useful information for clinical purposes. Nineteen studies were included. Sixteen researches identified a positive relationship between pre-natal attachment and parent-to-infant attachment, and three articles highlighted a negative association between antenatal attachment and post-partum bonding disorders. These results were found both in women and men, in normative and at-risk pregnancies, adopting different assessment approaches (i.e., self-report measures, observations, and projective measures). However, only small or moderate associations were found. Future studies are needed to further confirm these findings across different populations (e.g., male samples, non-normative samples or samples in disadvantaged conditions) and with different methodological approaches (e.g., observational measures). Moreover, studies would be needed in order to clarify mechanisms through which pre-natal attachment influences parent-to-infant attachment, as well as protective and risk factors which intervene between these two variables.
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Affiliation(s)
| | - Maura Giordano
- Department of Psychology, University of Torino, Torino, Italy
| | | | - Laura Vismara
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | | | - Luca Rollè
- Department of Psychology, University of Torino, Torino, Italy
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Alvarez Gutierrez S, Ventura AK. Associations between maternal technology use, perceptions of infant temperament, and indicators of mother-to-infant attachment quality. Early Hum Dev 2021; 154:105305. [PMID: 33508559 DOI: 10.1016/j.earlhumdev.2021.105305] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/10/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous research suggests parents' use of technological devices, such as TV and mobile devices, within family contexts may decrease the quality of parent-child interactions. During early infancy, mothers report engaging with technological devices during infant feeding and care interactions, however, few studies have explored potential associations between maternal technology use and the quality of mother-to-infant attachment. AIM To examine associations between maternal technology use during mother-infant interactions and indicators of mother-to-infant attachment during early infancy. STUDY DESIGN Cross-sectional survey. METHODS Mothers (n = 332) of infants aged 2 to 6 months were recruited via MTurk, a crowdsourcing platform, to participate in an online survey. Participants responded to a series of validated questionnaires that assessed maternal technology use during mother-infant interactions (Maternal Distraction Questionnaire), infant temperament (Infant Behavior Questionnaire-Revised Very Short Form), and indicators of mother-to-infant attachment, including quality of attachment, absence of hostility toward motherhood, and pleasure in mother-infant interactions (Maternal Postnatal Attachment Questionnaire). RESULTS Greater technology use during mother-infant interactions was significantly associated with greater infant negative affectivity (β = 0.26, p < .0001). Greater technology use was also significantly associated with lower mother-to-infant attachment quality (β = -0.21, p = .0001), and greater hostility toward motherhood (β = -0.39, p < .0001). Associations between technology use and indicators of mother-to-infant attachment were not mediated by infant negative affectivity. CONCLUSIONS Maternal technology use was associated with greater perceptions of infant negative affectivity and poorer mother-to-infant attachment quality; further research is needed to understand mechanisms underlying these associations.
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Affiliation(s)
- Shawnee Alvarez Gutierrez
- California Polytechnic State University, Department of Kinesiology and Public Health, College of Science and Mathematics, One Grand Avenue, San Luis Obispo, CA 93407, United States of America
| | - Alison K Ventura
- California Polytechnic State University, Department of Kinesiology and Public Health, College of Science and Mathematics, One Grand Avenue, San Luis Obispo, CA 93407, United States of America.
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Early identification of postpartum depression using demographic, clinical, and digital phenotyping. Transl Psychiatry 2021; 11:121. [PMID: 33574229 PMCID: PMC7878890 DOI: 10.1038/s41398-021-01245-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 12/03/2022] Open
Abstract
Postpartum depression (PPD) and adjustment disorder (AD) affect up to 25% of women after childbirth. However, there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention. Combinations of anamnestic, clinical, and remote assessments were evaluated for an early and accurate identification of PPD and AD. Two cohorts of mothers giving birth were included in the study (N = 308 and N = 193). At baseline, participants underwent a detailed sociodemographic-anamnestic and clinical interview. Remote assessments were collected over 12 weeks comprising mood and stress levels as well as depression and attachment scores. At 12 weeks postpartum, an experienced clinician assigned the participants to three distinct groups: women with PPD, women with AD, and healthy controls (HC). Combinations of these assessments were assessed for an early an accurate detection of PPD and AD in the first cohort and, after pre-registration, validated in a prospective second cohort. Combinations of postnatal depression, attachment (for AD) and mood scores at week 3 achieved balanced accuracies of 93 and 79% for differentiation of PPD and AD from HC in the validation cohort and balanced accuracies of 87 and 91% in the first cohort. Differentiation between AD and PPD, with a balanced accuracy of 73% was possible at week 6 based on mood levels only with a balanced accuracy of 73% in the validation cohort and a balanced accuracy of 76% in the first cohort. Combinations of in clinic and remote self-assessments allow for early and accurate detection of PPD and AD as early as three weeks postpartum, enabling early intervention to the benefit of both mothers and children.
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Boekhorst MGBM, Beerthuizen A, Hillegers M, Pop VJM, Bergink V. Mother-to-Infant Bonding in Women With a Bipolar Spectrum Disorder. Front Pediatr 2021; 9:646985. [PMID: 33816406 PMCID: PMC8017118 DOI: 10.3389/fped.2021.646985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: Offspring of mothers with a bipolar disorder are at high-risk for impaired developmental outcomes and psychopathology (e. g., mood, anxiety, sleep disorders) later in life. This increased risk of psychopathology is not only because of genetic vulnerability, but environmental factors may play an important role as well. The often long and debilitating mood episodes of mothers with bipolar disorder might hamper their qualities as a caregiver and may impact the child. We examined early mother-to-infant bonding 1 year postpartum in mothers with bipolar spectrum disorder as compared to mothers of the general population. The association between mother-to-infant bonding and the type of bipolar spectrum diagnosis (bipolar I, bipolar II, bipolar Not Otherwise Specified) as well as relapse within 12 months postpartum was also assessed. Methods: In total, 75 pregnant women with a bipolar spectrum disorder participated in the current study. The participants were included in a longitudinal cohort study of women with bipolar spectrum disorder and were prospectively followed from pregnancy until 1 year postpartum. Mother-to-infant bonding was assessed using the Pre- and Postnatal Bonding Scale. A longitudinal population-based cohort of 1,419 pregnant women served as the control group. Multiple linear regression analyses were used to assess the association between bipolar spectrum disorder and mother-to-infant bonding scores, controlling for several confounders. Results: Women with bipolar spectrum disorder perceived the bonding with their child as less positive compared to the control group. The type of bipolar spectrum disorder was not associated with poorer bonding scores. Relapse during the 1st year after delivery also did not affect bonding scores in women with bipolar spectrum disorder. Conclusions: Our findings could imply that women with bipolar spectrum disorder are more vulnerable to impairments in bonding due to the nature of their psychopathology, regardless of the occurrence of postpartum relapse. Careful follow-up including monitoring of mother-to-infant bonding of pregnant women with a history of bipolar spectrum disorder should be a standard to this vulnerable group of women. In addition, regardless of severity and mood episode relapse, an intervention to improve bonding could be beneficial for all mothers with bipolar spectrum disorder and their newborns.
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Affiliation(s)
- Myrthe G B M Boekhorst
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Veerle Bergink
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, Netherlands.,Departments of Psychiatry and Obstetrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Tichelman E, Henrichs J, Schellevis FG, Berger MY, Burger H. Development of a risk classification model in early pregnancy to screen for suboptimal postnatal mother-to-infant bonding: A prospective cohort study. PLoS One 2020; 15:e0241574. [PMID: 33147253 PMCID: PMC7641412 DOI: 10.1371/journal.pone.0241574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/17/2020] [Indexed: 12/23/2022] Open
Abstract
Background Previous studies identified demographic, reproduction-related and psychosocial correlates of suboptimal mother-to-infant bonding. Their joint informative value was still unknown. This study aimed to develop a multivariable model to screen early in pregnancy for suboptimal postnatal mother-to-infant bonding and to transform it into a risk classification model. Methods Prospective cohort study conducted at 116 midwifery centers between 2010–2014. 634 women reported on the Mother-to-Infant Bonding questionnaire in 2015–2016. A broad range of determinants before 13 weeks of gestation were considered. Missing data were described, analyzed and imputed by multiple imputation. Multivariable logistic regression with backward elimination was used to develop a screening model. The explained variance, the Area Under the Curve of the final model were calculated and a Hosmer and Lemeshow test performed. Finally, we designed a risk classification model. Results The prevalence of suboptimal mother-to-infant bonding was 11%. The estimated probability of suboptimal mother-to-infant can be calculated: P(MIBS≥4) = 1/(1+exp(-(-4.391+(parity× 0.519)+(Adult attachment avoidance score× 0.040))). The explained variance was 14% and the Area Under the Curve was 0.750 (95%CI 0.690–0.809). The Hosmer and Lemeshow test had a p-value of 0.21. This resulted in a risk classification model. Conclusion Parity and adult attachment avoidance were the strongest independent determinants. Higher parity and higher levels of adult attachment avoidance are associated with an increased risk of suboptimal mother-to-infant bonding. The model and risk classification model should be externally validated and optimized before use in daily practice. Future research should include an external validation study, a study into the additional value of non-included determinants and finally a study on the impact and feasibility of the screening model.
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Affiliation(s)
- Elke Tichelman
- Department of Midwifery Science, Amsterdam UMC, AVAG, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of General Practice & Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Jens Henrichs
- Department of Midwifery Science, Amsterdam UMC, AVAG, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - François G. Schellevis
- Department of General Practice & Elderly Care Medicine, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Marjolein Y. Berger
- Department of General Practice & Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice & Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Missler M, van Straten A, Denissen J, Donker T, Beijers R. Effectiveness of a psycho-educational intervention for expecting parents to prevent postpartum parenting stress, depression and anxiety: a randomized controlled trial. BMC Pregnancy Childbirth 2020; 20:658. [PMID: 33129314 PMCID: PMC7603696 DOI: 10.1186/s12884-020-03341-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/15/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The first months postpartum can be challenging for parents, leading to elevated symptoms of parenting stress, depression and anxiety. In turn, distressed parents are at higher risk for providing suboptimal quality of caregiving. As psychoeducational interventions can be effective in reducing psychological distress, the goal of this randomized controlled trial was to examine the effectiveness of low-intensity universal psychoeducational program to prevent postpartum parenting stress, and to enhance parental well-being and caregiving quality. METHOD Between 26 and 34 weeks of pregnancy, 138 pregnant women and 96 partners were randomized to the intervention or a waitlist control group. The intervention consisted of a booklet, a video, a home visit, and a telephone call. Information was provided on (1) sensitive responsiveness, adapting to the parental role, and attending to own needs; (2) crying patterns; (3) feeding (arrangements); and (4) sleeping (arrangements). The primary outcome was parenting stress postpartum. Secondary outcomes were additional measures of distress (depression and anxiety), parental well-being, and caregiving quality. RESULTS Both groups showed a rise in distress after birth. No between-group differences were observed on parenting stress, nor on the secondary outcomes. The intervention was rated as useful and of added value by the parents. CONCLUSION This study offered no evidence that our universal prevention program was effective in decreasing parental distress or in increasing caregiving quality. However, parents found aspects of the intervention useful. More research is needed, including a longer period of follow-up as well as observational measures of parents' responsiveness. TRIAL REGISTRATION This trial has been registered on 15 September 2016 in the Netherlands National Trial Register, ID: NTR6065, https://www.trialregister.nl/trial/5782 .
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Affiliation(s)
- Marjolein Missler
- Department of Clinical, Neuro and Developmental Psychology, Section of Clinical Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro and Developmental Psychology, Section of Clinical Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jaap Denissen
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Tara Donker
- Department of Clinical, Neuro and Developmental Psychology, Section of Clinical Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychology, Laboratory for Biological and Personality Psychology, Albert-Ludwigs-University of Freiburg, Stefan-Meier-Straße 8, D-79104 Freiburg im Breisgau, Germany
| | - Roseriet Beijers
- Radboud University, Behavioural Science Institute, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands
- Radboud University Medical Center, Donders Institute for Brain, Cognition & Behavior, Nijmegen, The Netherlands
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Obikane E, Watanabe K, Nishi D, Kawakami N. Association between personal values in adolescence and impaired bonding relationship with children. BMC Psychol 2020; 8:98. [PMID: 32917277 PMCID: PMC7488759 DOI: 10.1186/s40359-020-00463-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/31/2020] [Indexed: 12/04/2022] Open
Abstract
Background Bonding disorders happen as parents cannot build an affective relationship with children and are associated with their psychological and social conditions. Personal values impact well-being and psychological outcomes; however, how personal values influence bonding relationships is unknown. The purpose of the study was to investigate the relationship between personal values in adolescence recalled by adult participants and impaired bonding using a community-representative database. Methods We conducted a retrospective study using cross-sectional data of adults living with children in Japan. Personal values were evaluated by value priorities measured by 11 items from Personal Value Questionnaires, and commitment to values measured by a Japanese version of the Personal Values Questionnaires II. Impaired bonding was evaluated by five items from a Japanese-version of the Mother-to-Infant Bonding Scale. Odds ratios of value priorities and commitment to values for impaired bonding relationships were calculated after adjusting covariates. Results Of 13,920 people selected by probability proportionate sampling, 466 participants with children under 6 years old were selected for analysis. Personal values on improving society, graduating from school, positive evaluation from others, and pursuing one’s interest were negatively associated with impaired bonding relationship, while personal values on financial success were positively associated with impaired bonding relationship. Commitment to values were negatively associated with bonding problems. Conclusions While a future longitudinal study is needed, the present findings may indicate that personal values in adolescence are associated with their bonding relationship with children.
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Affiliation(s)
- Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Høifødt RS, Nordahl D, Landsem IP, Csifcsák G, Bohne A, Pfuhl G, Rognmo K, Braarud HC, Goksøyr A, Moe V, Slinning K, Wang CEA. Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby). BMC Psychiatry 2020; 20:300. [PMID: 32539729 PMCID: PMC7294655 DOI: 10.1186/s12888-020-02669-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant's signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up. METHODS This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up. RESULTS A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby's signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small. CONCLUSIONS The results indicate that the NBO-group learned more than the comparison group about reading their child's signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample. TRIAL REGISTRATION ClinicalTrials, NCT02538497, Registered 2 September 2015.
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Affiliation(s)
- Ragnhild Sørensen Høifødt
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Dag Nordahl
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
| | - Inger Pauline Landsem
- grid.412244.50000 0004 4689 5540Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway ,grid.10919.300000000122595234Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gábor Csifcsák
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Agnes Bohne
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
| | - Gerit Pfuhl
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kamilla Rognmo
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Hanne C. Braarud
- grid.477239.cDepartment of Social Science, Faculty of Health and Social Science, Western Norway University of Applied Sciences, Bergen, Norway ,Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Arnold Goksøyr
- grid.477239.cDepartment of Social Science, Faculty of Health and Social Science, Western Norway University of Applied Sciences, Bergen, Norway ,Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Vibeke Moe
- grid.5510.10000 0004 1936 8921Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Kari Slinning
- Regional Centre for Child and Adolescent Mental Health East and South, Oslo, Norway
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Nordahl D, Rognmo K, Bohne A, Landsem IP, Moe V, Wang CEA, Høifødt RS. Adult attachment style and maternal-infant bonding: the indirect path of parenting stress. BMC Psychol 2020; 8:58. [PMID: 32513300 PMCID: PMC7278048 DOI: 10.1186/s40359-020-00424-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/21/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The quality of maternal-infant bonding is related to important child outcomes. The literature has assumed that the ability to form relationships is a relatively stable trait, and research studies have suggested that a mother's attachment style in close adult relationships is related to mother-infant bonding. The transition to parenthood is also often stressful, and the adult attachment style may relate to parenting stress in the first year after birth. Such stress could possibly have a negative relationship with the mother-infant bond. In the present study, we examined the associations between maternal adult attachment styles and the quality of mother-infant bonding and whether this relationship is mediated by parenting stress. METHODS The present study sample comprised 168 women (mean age 31.0 years, SD 4.23 years). Between weeks 31 and 41 of gestation, the anxious and avoidant adult attachment dimensions were measured with the Experiences in Close Relationships questionnaire (ECR). Between 5 and 15 weeks after birth mother-infant bonding and parenting stress were measured with the Maternal Postnatal Attachment Scale (MPAS) and the Parenting Stress Index-Parent Domain (PSI-PD), respectively. RESULTS Both attachment-related avoidance and attachment-related anxiety correlated significantly and negatively with mother-infant bonding. However, a regression analysis showed that only attachment-related avoidance was a significant predictor of mother-infant bonding when controlling for demographic variables and maternal mental health history. The relationship between the adult attachment style and bonding was mediated by parenting stress. Higher scores on attachment avoidance and anxiety were related to increased stress, which was related to decreased quality of bonding. The overall parent domain and the subscale of competence in the parent-related stress dimension mediated between attachment avoidance and bonding, and the overall parent domain and the subscales of competence and role restriction mediated between attachment anxiety and bonding. There was no direct relationship between the adult attachment style and mother-infant bonding when parenting stress was included as a mediator. CONCLUSIONS This study illustrates that maternal adult attachment style relates to mother-infant bonding. This relationship was mediated by parenting stress. The results may have implications for the early identification of mothers at risk of having bonding difficulties.
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Affiliation(s)
- Dag Nordahl
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway.
| | - Kamilla Rognmo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Agnes Bohne
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
| | - Inger Pauline Landsem
- Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vibeke Moe
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, East and South, Norway
| | | | - Ragnhild Sørensen Høifødt
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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