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Wenze SJ, Mikula CM, Battle CL. Two babies, two bonds: Frequency and correlates of differential maternal-infant bonding in mothers of twins. Infant Ment Health J 2024; 45:286-300. [PMID: 38403982 DOI: 10.1002/imhj.22108] [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: 04/25/2023] [Revised: 01/18/2024] [Accepted: 02/02/2024] [Indexed: 02/27/2024]
Abstract
We assessed prevalence and correlates of differential maternal-infant bonding (i.e., experiencing a stronger bond with one baby vs. the other) in mothers of twins, focusing on aspects of maternal mental health, well-being, and pregnancy/birth that have been previously linked with maternal-infant bonding. Participants (N = 108 American women, 88.89% White, 82.41% non-Hispanic, aged 18-45, who gave birth to twins in the past 6-24 weeks) were recruited from postpartum support websites. Participants completed a Qualtrics survey assessing pregnancy/birth history, symptoms of depression and anxiety, sleep, stress, romantic relationship satisfaction, and postpartum bonding. Twenty-six participants (24.07%) reported a bonding discrepancy. These participants endorsed higher symptoms of depression and anxiety, lower relationship satisfaction, lower average postpartum bonding, higher general and parenting stress, and longer pregnancy (all ps > .05). Greater degree of bonding discrepancy correlated with more depression, higher parenting stress, longer pregnancy, and lower relationship satisfaction (all ps > .05). Mothers of twins may benefit from postpartum mental health support, stress management strategies, and interventions to improve bonding. Future work should assess the role of breastfeeding difficulties, delivery method, birth-related trauma, infant regulatory capacity, and temperament. Longitudinal studies will help test cause and effect and potential long-term repercussions of maternal-infant bonding discrepancies.
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Affiliation(s)
- Susan J Wenze
- Department of Psychology, Lafayette College, Easton, Pennsylvania, USA
| | - Cynthia M Mikula
- Department of Psychology, Lafayette College, Easton, Pennsylvania, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Women and Infants' Hospital of Rhode Island, Providence, Rhode Island, USA
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Kang LJ, Koleva PT, Field CJ, Giesbrecht GF, Wine E, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Sears MR, Scott JA, Kozyrskyj AL. Maternal depressive symptoms linked to reduced fecal Immunoglobulin A concentrations in infants. Brain Behav Immun 2018; 68:123-131. [PMID: 29032226 DOI: 10.1016/j.bbi.2017.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/30/2017] [Accepted: 10/10/2017] [Indexed: 01/23/2023] Open
Abstract
Secretory Immunoglobulin A (sIgA) plays a critical role to infant gut mucosal immunity. Delayed IgA production is associated with greater risk of allergic disease. Murine models of stressful events during pregnancy and infancy show alterations in gut immunity and microbial composition in offspring, but little is known about the stress-microbiome-immunity pathways in humans. We investigated differences in infant fecal sIgA concentrations according to the presence of maternal depressive symptoms during and after pregnancy. A subsample of 403 term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) cohort were studied. Their mothers completed the Center of Epidemiologic Studies Depression Scale when enrolled prenatally and again postpartum. Quantified by Immundiagnostik sIgA ELISA kit, sIgA from infant stool was compared across maternal depressive symptom categories using Mann-Whitney U-tests and logistic regression models that controlled for various covariates. Twelve percent of women reported clinically significant depressive symptoms only prenatally, 8.7% had only postpartum symptoms and 9.2% had symptoms both pre and postnatally. Infants born to mothers with pre and postnatal symptoms had significantly lower median sIgA concentrations than those in the reference group (4.4 mg/g feces vs. 6.3 mg/g feces; p = 0.033). The odds for sIgA concentrations in the lowest quartile was threefold higher (95% CI: 1.25-7.55) when mothers had pre and postnatal symptoms, after controlling for breastfeeding status, infant age, antibiotics exposure and other covariates. Postnatal symptoms were not associated with fecal sIgA, independently of breastfeeding status. Infants born to mothers with depressive symptoms appear to have lower fecal sIgA concentrations, predisposing them to higher risk for allergic disease.
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Affiliation(s)
- Liane J Kang
- Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Petya T Koleva
- Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-126A Li Ka Shing Center for Health Research Innovation, Edmonton, Alberta T6G 2E1, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, CDC, Owerko Centre, Room 355, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada; Department of Community Health Sciences, University of Calgary, CDC, Owerko Centre, Room 355, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
| | - Eytan Wine
- Department of Pediatrics, University of Alberta, 4-577 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, University of Manitoba, 513 - 715 McDermot Avenue Winnipeg, Manitoba R3E 3P4, Canada
| | - Piushkumar J Mandhane
- Department of Pediatrics, University of Alberta, 1048B Research Transition Facility, Edmonton, Alberta T6G 2V2, Canada
| | - Stuart E Turvey
- Department of Pediatrics, University of British Columbia, BC Children's Hospital, Room A2-147, 950 W 28th Avenue, Vancouver, British Columbia V5Z 4H4, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Peter Gilgan Center for Research and Learning, 686 Bay Street, 10-9716, Toronto, Ontario M5G 0A4, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, 50 Charlton Avenue E., Hamilton, Ontario L8N 4A6, Canada
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, 223 College Street, Toronto, Ontario M5T 1R4, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada; School of Public Health, University of Alberta, 3-527 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada.
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Letourneau NL, Kozyrskyj AL, Cosic N, Ntanda HN, Anis L, Hart MJ, Campbell TS, Giesbrecht GF. Maternal sensitivity and social support protect against childhood atopic dermatitis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2017; 13:26. [PMID: 28559916 PMCID: PMC5446757 DOI: 10.1186/s13223-017-0199-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/17/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Many studies have identified associations between qualities of maternal-child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal-infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. METHODS We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. RESULTS Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. CONCLUSIONS Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal-infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.
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Affiliation(s)
- Nicole L. Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Anita L. Kozyrskyj
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Nela Cosic
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Henry N. Ntanda
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Lubna Anis
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Martha J. Hart
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Tavis S. Campbell
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Gerald F. Giesbrecht
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - The APrON Team
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
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Kozyrskyj AL, Letourneau NL, Kang LJ, Salmani M. Associations between postpartum depressive symptoms and childhood asthma diminish with child age. Clin Exp Allergy 2016; 47:324-330. [PMID: 27770463 DOI: 10.1111/cea.12837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/16/2016] [Accepted: 09/15/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Affecting 19% of women, postpartum depression is a major concern to the immediate health of mothers and infants. In the long-term, it has been linked to the development of early-onset asthma at school entry, but only if the depression persists beyond the postnatal period. No studies have tested whether associations with postpartum depressive symptoms and early-onset asthma phenotypes persist into later school age. OBJECTIVE To determine associations between maternal postpartum depressive symptoms and childhood asthma between the ages of 5-10 by using a nested longitudinal design. METHODS Data were drawn from the 1994-2004 administrations of the Canadian National Longitudinal Survey of Children and Youth, which tracks the health of a nationally representative sample of children in Canada. Child asthma was diagnosed by a health professional, and maternal depressive symptoms were assessed by the Centre for Epidemiological Studies Depression scale. Analyses were conducted by using a multilevel modelling approach, in which longitudinal assessments of asthma in 1696 children were nested within the exposure of postpartum depression. RESULTS Postpartum depressive symptoms had a 1.5-fold significant association with childhood asthma between the ages 6-8. This was independent of male sex, maternal asthma, non-immigrant status, low household socioeconomic status, being firstborn, low birthweight, low family functioning and urban-rural residence, of which the first 4 covariates elevated the risk of asthma. Statistical significance was lost at age 8 when maternal prenatal smoking replaced urban-rural residence as a covariate. At ages 9-10, an association was no longer evident. CONCLUSIONS AND CLINICAL RELEVANCE Women affected by postpartum depressive symptoms are concerned about long-term health effects of their illness on their infants. Although postpartum depressive symptoms were associated with school-age asthma at ages 6 and 7, this association diminished later. Both home and school life stress should be considered in future studies on asthma development later in childhood.
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Affiliation(s)
- A L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,School of Public Health, University of Alberta, Edmonton, AB, Canada.,Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - N L Letourneau
- Faculty of Nursing & Cumming School of Medicine (Pediatrics & Psychiatry), University of Calgary, Calgary, AB, Canada
| | - L J Kang
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - M Salmani
- Department of Mathematics & Statistics, University of New Brunswick, Fredericton, NB, Canada
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