The association between epidural analgesia during labor and mother-infant bonding

Abstract

Study objectiveThis study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding. DesignA cross-sectional study. SettingMaternity ward at Soroka University Medical Center during 2020. PatientsWomen who delivered a singleton live-born infant vaginally in their immediate post-partum period. InterventionsWomen completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression. MeasurementsThe study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post- partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub- scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records. Main resultsA total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother -infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother -infant bonding total score and better impaired bonding sub-scale score (Beta coefficient-0.252, 95% CI -0.5; −0.006, p = 0.045 and Beta coefficient − 0.34, 95% CI -0.52; −0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS≥13, 5.7% vs. 13%, p = 0.058). ConclusionOur study demonstrated better mother -infant bonding among women delivering with epidural analgesia.