Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant’s Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study

(1) Background: There is a continuing discussion concerning the impact of preterm birth on Maternal-Infant bonding with inconsistent results. The large burden of preterm births calls for research to evaluate the impact of it on material psychological outcome in the early postpartum period. Thus, the aim of this study was to evaluate the relationship between maternal postpartum bonding with maternal mental health, socio-demographical factors, and child’s characteristics. (2) Methods: A cross-sectional study design was used. In total, 72 women (a mean age of 31.44 years old) of preterm infants (mean gestational age = 33.54; range 24–36) filled out socio-demographic questionnaires, Postpartum Bonding Questionnaire (PBQ), Edinburgh Postpartum Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), Generalized Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS) 1–3 days post-delivery; (3) Results: The results analyses have shown positive correlations between the overall result of maternal postpartum bonding with stress (p < 0.01), maternal educational level (p < 0.01), maternal age (p < 0.05) and the number of children (p < 0.01). However, there were no significant relationships between other investigated variables. The results of linear regression have revelated the important role of the overall scores in experience of stress among mothers (explaining 49% of the variability). The mediating role of maternal stress on maternal postpartum bonding was not found. That relationship of maternal postpartum bonding and maternal stress was not moderated through socio-demographic variables. (4) Conclusions: In this study mothers of prematurely born children had a good level of Maternal-Infant bonding. Maternal stress was found to be a predictor of maternal postpartum bonding among the tested variables. Surprisingly, the study results did not show significant relationships between maternal postpartum bonding and maternal mental health (depression and anxiety).

Translation of Postpartum Bonding Questionnaire (PBQ) In Urdu Language

Postpartum Bonding Questionnaire (PBQ) was widely used to measure the emotional thoughts of mothers towards the infant. Postpartum Bonding Questionnaire is helpful for the assessment of mother-infant bonding problems in mothers with postpartum depression. Therefore it is necessary to translated PBQ into Urdu language to make it understandable for Pakistani mothers. In the present study, Postpartum Bonding Questionnaire (PBQ) developed by Brockington et al. (2001) and revised by Brockington, Fraser and Wilson (2006) was translated for the assessment of mother-infant bonding problems in a sample of Pakistani postpartum mothers with postpartum depression. Four hundred postpartum mothers were screened on Edinburgh Postnatal Depression Scale (EPDS) and 150 depressed mothers of age range 18 to 45 years were selected to participate in the study through purposive sampling technique. PBQ was translated into Urdu using Back-translation method of Brislin (1976). The alpha reliability coefficients for the subscales of Postpartum Bonding Questionnaire Urdu –version were ranged from .33 to .93. Findings also showed that PBQ has satisfactory internal validity. The PBQ Urdu-version would be very useful for identifying problems of the mother-infant bonding in mothers with postpartum depression. In the future researches PBQ Urdu-version would also be useful for the researchers working in the same area.

Perinatal mental health outcome measures in a mother and baby unit

AimsTo Audit Perinatal outcome measures and understand better the population served in order to improve care and understand risks. Our audit standards inculded: paired HoNOS and PBQ recorded on admission and discharge as well as ASQ scores prior to admission.MethodHealth of the Nation Outcome Scales (HoNOS), Postpartum Bonding Questionnaire (PBQ) and Ages and Stages Questionnaires (ASQ) were recorded on Lorenzo and SystmOne. Scores were collected over 20 months within the same MBU and these were analyzed.ResultOur audit standards had an overall audit compliancy of 73% with paired HoNOS better than PBQ. Mental health severity mitigated and maternal bonding improved to a significant degree. Depression was the principal presentation as were patients from deprived areas. Only 55% of babies had ASQ scores completed appropriately pre- admission.ConclusionAs the newest MBU in the country, this an initial foray of perinatal outcomes. Gratifyingly, benefits of MBU admission for mother and baby is evidenced in this snapshot.

Negative effect of dietary elimination on breastfeeding mothers having infants with and without food allergy

Background: There has been no trial evaluating the psychopathology in breastfeeding mothers of infants with food allergy (FA). Objective: To investigate the effect of dietary elimination on maternal psychopathology, specifically stress/anxiety and mother-to-infant bonding and explore the importance of sociodemographic features on these variables. Methods: Breastfeeding mothers following an elimination diet due to FA in their children aged 1-to-12 months were compared with the healthy controls. Physician-diagnosed FA group were divided into IgE-, non-IgE-mediated and infants with some minor symptoms which were not enough to make the diagnosis of FA were classified as Indecisive symptoms for FA group. Mothers completed standardized questionnaires including Symptom Checklist 90R, Beck Depression/Anxiety Inventories (BDI/BAI), Postpartum Bonding Questionnaire (Bonding). Results: Of 179 mother-infants, 64 were healthy, 89 were FA, 16 were indecisive symptoms for FA. The mean age of the mothers and infants were 31.1±4.7 years and 6.3±3.6 months. The physician diagnosed FA groups had higher scores for anxiety (p=0.008), anger (p=0.042), depression (p<0.001), obsession (p=0.002), phobia (p=0.008), somatization (p=0.002) and general symptom index (GSI) (p=0.001), BDI (p<0.001), BAI (p=0.008) and Bonding [attachment (p=0.001), anger (p=0.019) and total (p=0.036)] than the healthy. The indecisive symptoms for FA group had a similar score pattern to physician-diagnosed FA except interpersonal sensitivity, BDI and attachment. Conclusion: Breastfeeding mothers of infants with FA were anxious, depressive and had many psychopathologies which affected bonding. Interventions targeting negativity in caregivers’ social relationships are urgently needed.

PSYCHOMETRIC ANALYSIS OF THE SLOVAK VERSION OF THE POSTPARTUM BONDING QUESTIONNAIRE FOR NON-CLINICAL SAMPLE

"Bonding represents an emotional tie that one experiences towards one´s own child. There are several instruments to measure the level and quality of bonding. Among them we chose and translated the Postpartum Bonding Questionnaire by Brockington et al. (2001) into Slovak language. The aim of this study was to analyse its psychometric qualities. Our non-clinical sample consisted of women (N= 372) 18 and 44 years (M= 29.74; SD= 5.25) who recently gave birth in Slovakian hospitals. Data collection was carried out from September 2015 until March 2018. Participants filled the Postpartum bonding questionnaire by Brockington et al. (2001) and some of them other three tools: Edinburgh Postnatal Depression Scale by Cox, Holgen and Sagovsky (1987), Depression Anxiety Stress scale-42 (Lovibond & Lovibond, 1995) and Parental Stress Scale (Berry & Jones, 1995). The distributions of the items of the bonding were mostly skewed and leptokurtic. Internal consistency is high for the overall Lack of Bonding (?= .897) and varies in factors- ?= .820 for Impaired Bonding, ?= .779 for Rejection and Anger, ?= .506 for Anxiety about Care and ?= .321 for Risk of Abuse. In order to prove convergent validity, we correlated overall Lack of Bonding with depression (Edinburgh Postnatal Depression Scale, rs= .251, Depression Anxiety Stress scale-42 depression rs=.404; n=79), stress and anxiety (Depression Anxiety Stress scale-42, stress rs=.392; anxiety rs=.496; n=79) and parental stress (Parental Stress Scale score; rs= .674, n=99). We did not confirm original factor structure via confirmatory factor analysis using principal axis factoring with oblimine rotation. Then, we used principal component analysis with varimax rotation method to reduce the items. 6 components were extracted. Component 1 was comprised of 15 items that explained 35,6 % of the variance with loadings from .306 to .733. Hence, we proposed new item-structure for the Slovak PBQ. We concluded that the Slovak version of the PBQ proved to have good overall reliability. We found evidences for the convergent validity with parental stress, anxiety, stress, and partly depression, because there were two different results. We also suggest creating a shorter version based on the analysis. Among limits we can see tools used for validity evidence and sample without participants for clinical population. We advise to use the Slovak version of the Postpartum Bonding Questionnaire as a tool to measure bonding in a research context and to use overall summary index (Lack of Bonding) instead of factors."

Paternal Postpartum Bonding and Its Predictors in the Early Postpartum Period: Cross-Sectional Study in a Polish Cohort

Introduction: Parental postpartum bonding has been studied by many researchers focusing on maternal bonding. The objective of this study was to examine the psychological and socio-demographic predictors of paternal postpartum bonding in the early postpartum period.Methods: In this cross-sectional study, 131 couples (fathers median age of 32.37 years, SD = 4.59; mothers median age of 30.23 years, SD = 3.90) of newborns from full-term pregnancies were recruited from November 2019 until March 2020. The primary outcome was paternal postpartum bonding as measured by the Postpartum Bonding Questionnaire (PBQ). Secondary outcomes included: maternal and paternal anxiety [with the Generalized Anxiety Disorder (GAD) Assessment]; maternal and paternal stress [with the Parental Stress Scale (PSS)]; maternal depressive symptoms [with the Edinburgh Postpartum Depression Scale (EPDS)]; and maternal and paternal socio-demographic variables as fathers’ presence at childbirth, education level, age, and parental experience.Results: Paternal postpartum bonding was significantly correlated with paternal anxiety (moderate strength), maternal stress (strong correlation), and maternal postpartum bonding. No significant correlations between paternal postpartum bonding, maternal depression symptoms, and maternal anxiety were found. The mediating role of paternal stress in paternal postpartum bonding was proven. Paternal anxiety strengthens paternal stress (b = 0.98). Further, a high level of paternal stress disrupts paternal postpartum bonding (b = 0.41). Results of regression analyses have revelated that maternal infant bonding (p &lt; 0.01) and paternal stress (p &lt; 0.01) are the only predictors of parental postpartum bonding across all included variables. None of investigated socio-demographic variables were associated with paternal postpartum bonding.Conclusion: Notwithstanding limitations, the current findings add to a growing body of literature on paternal postpartum bonding. The results have shown that paternal mental health is related to parental postpartum bonding directly after delivery.Clinical Trial Registration:ClinicalTrials.gov Identifier: NCT04118751.