Background
The majority of women who have given birth will develop affection for their
infants, however some have prolonged problems developing a loving attitude,
leading to impaired mother-infant bonding. Some studies have found an
association between postnatal depression and poor mother-infant bonding. On
the other hand, little is known about the antenatal predictors of this problem.
Aim
The aim of this study was to determine if it is possible to predict during
pregnancy which women will develop impaired mother-infant bonding; and to
assess whether having a high risk pregnancy could affect this bond.
Method
A prospective cohort study was conducted with women who were recruited from
one London Hospital between 2008 and 2012. Psychometric data were
collected from 300 women in late pregnancy; 223 were followed up at six weeks
postnatal using self-administered questionnaires. Sixty-six of these women had
a high risk pregnancy. Saliva samples were collected from a subsample of
participants (N=46) as part of a pilot study to physiologically measure cortisol
and alpha-amylase (as biological markers of maternal stress and depression)
embedded within the main study.
Results
There was a lower risk of impaired mother-infant bonding at six weeks
postnatal, if the woman had good fetal bonding in late pregnancy(OR=0.89,
95%CI=0.83-0.94, p<0.001), but a higher risk of impaired maternal bonding at
this time, if the woman had symptoms of depression during pregnancy
(OR=1.12, 95%CI=1.11-1.41, p<0.05). Another determinant of poor motherinfant
bonding in the study was postnatal depressive symptoms and having an
epidural analgesia during labour and birth, although reasons for this need
further consideration. There were no significant differences in mother to infant
bonding status between women who had a high or a low risk pregnancy.
Conclusion
Maternal mental health and fetal bonding emerged as the strongest predictors
of impaired maternal-infant bonding, together with the negative association with
having an epidural analgesia. The findings from this study highlight the
importance of training for clinicians to be aware that mother-infant bonding
problem can develop during pregnancy. The negative effect of epidural
analgesia on mother-infant bonding warrants further investigation.
Antenatal predictors of early mother-to- infant bonding failure: A prospective cohort study
Agbagwara-Osuji, B. O. (Author). 2015
Student thesis: Doctoral Thesis › Doctor of Philosophy