Poor Mothers Research Articles

The double burden of maternal overweight and short stature and the likelihood of cesarean deliveries in South Asia: An analysis of national datasets from Bangladesh, India, Maldives, Nepal, and Pakistan.

The aim was to investigate: (a) whether there is an association between the maternal double burden of overweight and short stature and the risk of cesarean delivery and (b) whether socioeconomic status (SES) acts as a moderator in the association between the maternal double burden of overweight and short stature and the risk of cesarean birth (CB). The data for this study were obtained from the nationally representative Demographic and Health Survey databases of five South Asian countries. The analyses were based on responses from married women between 15 and 49years of age. The risk of CB was the primary outcome, while the maternal double burden of overweight and short stature (coexistence of overweight and short stature) was the exposure of interest. Maternal double burden of overweight and short stature was significantly associated with 179% higher likelihood of undergoing CB in South Asia (SA), with 304%, 200%, 167%, 155%, and 125% higher likelihood of undergoing CB in Nepal, Pakistan, India, Maldives, and Bangladesh, respectively. Findings also demonstrated that mothers belonging to low SES groups with a double overweight and short stature burden were not uniquely disadvantaged. A significant marker in SA of higher risk of CB is the maternal double burden of overweight and short stature. The negative effect of the maternal double burden of overweight and short stature extends across all economic backgrounds in relation to the risk of CB. It is not limited to poor mothers who suffer from the double burden of overweight and short stature.

Effectiveness of Breast Massage on Amount of Milk Production in Mothers who are not Actively Breast Feeding Preterm Babies

ontext: Breastfeeding to premature baby is often challenging for the postnatal mothers. In case of preterm labour milk synthesis is poor due to insufficient sucking reflex and poor mother baby bonding, if baby is admitted in neonatal unit. Breast massage is a technique to improve milk production in lactating mothers. Aims: To assess the effectiveness of breast massage on amount of milk production in mothers who are not actively breast feeding preterm babies. Settings and Design: Setting was postnatal ward Queen Mary Hospital, Lucknow. Research design was quasiexperimental (time series one group pre test post test). Methods and Material: Data were collected with the help of demographic profile and assessment of breast milk tool from 26 samples using purposive sampling technique who met the inclusion criteria. The pretest data collected before intervention and post test data collected after each intervention consecutively for 3 days. Statistical Analysis used: Mean, mean difference, standard deviation, t-test and chi-square. Results: The result revealed that on day 1, the post intervention milk production was found to be more (12.34±3.83) than pre intervention (3.03±1.98), t =16.68. On day 2, the post intervention milk production was found to be more (60.61±20.52), than pre intervention (17.07±6.73), t= 15.62 . On day 3, the pre intervention milk production was 25.15±7.13, which increased to 81.92±21.10 after intervention, t=20.16 at 0.05 level of significance. Conclusions: The findings of the study conclude that breast massage was found to be effective in increasing the amount of milk production among mothers who are not actively breast feeding preterm babies.

Decadal change in the association between the status of young mother\u2019s Body Mass Index and anaemia with child low birth weight in India

BackgroundThe study aims to investigate the changes in the socio-economic and demographic status of young mothers of age 15–24 years and to examine the association between mothers’ nutrition, i.e., Body Mass Index (BMI) and anaemia with child low birth weight for almost two decades during 1998–2016 in India.MethodsNational Family Health Survey (NFHS) round II and IV were used. The sample of this study included 3405 currently married young mothers from NFHS II and 44,742 from NFHS IV who gave birth at least one child in the last three years preceding the surveys. Logistic regression and Blinder-Oaxaca decomposition analysis have been used in this study to examine the corresponding association between the concerned variables.ResultsThe analysis showed that the prevalence of low birth weight (LBW) babies has decreased from 26.1 to 22.8 for the 15 to 19 age group and from 20.4 to 18.7 for the 20 to 24 age group over time. Young mothers with low BMI or severe anaemia have shown higher odds of having LBW babies. For instance, the odds of having a LBW child was 1.44 (p-value = 0.000; 95% CI: 1.05, 1.65) for mothers with low BMI and 1.55 (p-value = 0.000; 95% CI: 1.27, 1.90) with severe anaemia. Over the decade, the association of LBW babies with mothers’ nutrition has decreased. The odds of LBW with mothers with low BMI decreased from 1.63 (p-value = 0.004; 95% CI: 1.21, 2.21) to 1.41 (p-value = 0.000; 95% CI: 1.27, 1.55). Similarly, mothers with severe anaemia, the odds of LBW child decreased from 2.6 (p-value = 0.000; 95% CI: 1.75, 3.8) in 1998 to 1.3 (p-value = 0.024; 95% CI: 1.02, 1.65) in 2016.ConclusionsThe maternal and child health improvement in India has been moderate over the decade. Still, a significant proportion of the women are suffering from poor health and young mothers are at more risk to deliver LBW babies. It is highly recommended to integrate maternal and child health programmes with the ongoing health policies to improve the situation while taking additional care of the young pregnant mother and their nutritional health.

Poor Queer Studies: Confronting Elitism in the University

Poor Queer Studies: Confronting Elitism in the University

Why did COVID-19 not further harm the mental health of poor mothers? A mixed-method study on low-income families in Singapore

ObjectivesThis paper examines the impact of COVID-19 pandemic on a disadvantaged group of financially poor mothers’ mental health conditions in Singapore during the phase of acute COVID-19 infection.DesignA mixed-method design...

Effects of integrated psychosocial stimulation (PS) and Unconditional Cash Transfer (UCT) on Children's development in rural Bangladesh: A cluster randomized controlled trial

BackgroundThere is evidence on benefits of psychosocial stimulation (PS) and cash transfer programmes in low- and middle-income countries on children's development. We integrated PS into an unconditional cash transfer (UCT) programme for poor Bangladeshi mothers to examine the effects on children's development. MethodsThis cluster randomized controlled trial was conducted in rural Bangladesh from July 2017 to December 2018 in 33 clusters, with 11 clusters randomly assigned to each of the three arms, namely i) PS + UCT ii) UCT-only and iii) Comparison. We enrolled poor mothers and child (6–16 months) dyads eligible to receive maternity allowance by the Government of Bangladesh. Trained local women imparted training to mothers to provide psychosocial stimulation to their children for one year. Children's cognitive, language and motor development were measured with Bayley-III, behaviour with Wolke's ratings and maternal self-esteem with Rosenberg self-esteem scale. The analysis was intention-to-treat. ResultsOf the 594 mother-child dyads, 40 (6·8%) were lost to follow-up. Compared to UCT-only, children in the PS + UCT had significant improvement in cognitive (B = 2.96, 95% CI: 0.46–5.47, Effect Size [ES] 0.24SD) and language (2.73, 0.39–5.00, ES 0.21SD) scores and were more responsive to examiner (0.30, 0.06–0.52, ES 0.27SD), while compared to comparison group, they had significantly higher cognitive (3.37, 1.27–6.19, ES 0.32SD), language (2.82, 0.53–5.10, ES 0.24SD) and motor (2.65, 0.24–5.06, ES 0.22SD) scores and were more responsive to examiner (0.30, 0.08–0.52, ES 0.26 SD). The mothers’ self-esteem was significantly higher in PS + UCT (2.46, 0.94–3.98, ES 0.48 SD) and UCT-only (1.67, 0.02–3.20, ES 0.32 SD) compared to the comparison group. ConclusionPS integrated into an UCT programme benefited children's neurodevelopment and UCT improved mother's self-esteem. UCT programme may be an important platform for child stimulation programmes for rural poor populations.

Desert locust swarms and child health

This study evaluates how in-utero exposure to an insect pest invasion, particularly, the outbreak of desert locust swarms, affects early childhood health in Africa and Asia over the past three decades (1990–2018). Employing the difference-in-differences model, we find that children being prenatally exposed to the outbreak have their height-for-age, weight-for-height, and weight-for-age z-scores lower by 0.159, 0.148, and 0.155 standard deviations, respectively, compared to unexposed children. Our heterogeneity analyses show that the health setbacks disproportionately fall on children of disadvantaged backgrounds, i.e., those born to lower-educated mothers, poorer mothers, and rural mothers. To the extent that poor health in early life exerts long-lasting irreversible consequences over the life cycle, the study calls for effective measures to minimize the pernicious effects of the desert locust swarm outbreak.

Relationships Between Childhood Health Experience and Depression Among Older People: Evidence From China.

The assessment of childhood health experience helps to identify the risk of depression among older people. Poor childhood experience is generally associated with depression in adulthood. However, whether such association can be extended to older people’ life remains unclear. The history of parental mental health was obtained from 2014 CHARLS Wave 3 (Life History Survey) data while other data from 2011 CHARLS Wave 1 baseline data. The study involves 4,306 respondents. The depression was assessed by the Chinese version of Center for Epidemiologic Studies Depression scales (CES-D) using logistic regression model. More than 40% of older people suffered from depression, 25% of whom experienced poor childhood self-reported health. Nearly 20% of their mothers and more than 10% of their fathers had a history of poor mental health. Poor childhood health experiences have shown to be associated with higher odds of depression (good self-reported health OR: 0.732, p = 0.000, 95% CI: 0.633–0.847; poor mother’s mental health OR: 1.391, p = 0.001, 95% CI: 1.138–1.699; poor father’s mental health OR: 1.457, p = 0.003, 95% CI: 1.141–1.862). There is a high rate of depression among the older adults in China. In China, older people with poor childhood health experiences are more likely to suffer from depression.

Social inequalities in maternal depressive symptomatology after childbirth: Comparison across birth cohorts in Brazil

• Depressive symptomatology increased amongst southern women in the postpartum period;. • Depressive symptomatology amongst women residents in the north decreased over time;. • Black/brown women showed higher frequencies of depressive symptomatology;. • Poor mothers showed the highest frequencies of depressive symptomatology;. • Socioeconomic and skin colour inequalities remained stable over the studied period. Approximately 40% of women experience their first depressive episode during the postpartum period. In Brazil, several maternal health outcomes are affected by profound social inequalities. Investigating inequalities in maternal depressive symptomatology in two different regions of the country in the first 24 months after childbirth may help clarify these patterns and appropriate support services. Data from three birth cohorts from two Brazilian cities (Cruzeiro do Sul, North region, and Pelotas, South region) were analysed. The baseline of each cohort consisted of 4,231 (2004 Pelotas), 4,275 (2015 Pelotas), and 1,246 (MINA-Brazil) live births. Depressive symptomatology was repeatedly measured using the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, and 24 months postpartum. Socioeconomic status and skin colour inequalities in depressive symptomatology were analysed at each point. Between the 3rd and 24th months postpartum, maternal depressive symptomatology increased amongst women from the south, but decreased amongst women in the north. Black/brown women and those belonging to the lowest socioeconomic stratum showed the highest frequency of depressive symptomatology. Absolute and relative inequalities remained stable throughout the study period. Depressive symptomatology was most common amongst women with few years of schooling, multiparae, and amongst those who smoked during pregnancy. There was no information regarding any psychological/psychiatric treatment at the time the EPDS was evaluated, and economic status was assessed differently amongst the cohorts. Marked social inequalities were found in postpartum depressive symptoms. Actions aimed at early detection and reducing social inequalities in maternal postpartum depressive symptomatology are vital.

Age-appropriate feeding practices and their association with undernutrition among children aged 6-23 months in aspirational districts of India: a multinomial analysis.

'Health and nutrition' is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6-23 months as this affects child development. This study used National Family Health Survey 2015-16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6-23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6-23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother's lower educational level, mother's lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.

Early Timing and Determinants of the Sexual Orientation Disparity in Internalizing Psychopathology: A Prospective Cohort Study from Ages 3 to 15.

Knowing the age at which the sexual orientation disparity in depression and anxiety symptoms first emerges and the early determinants of this disparity can suggest optimal timing and targets of supportive interventions. This prospective cohort study of children ages 3 to 15 (n = 417; 10.6% same-sex-attracted; 47.2% assigned female at birth) and their parents sought to determine the age at which the sexual orientation disparity in depression and anxiety symptoms first emerges and whether peer victimization and poor parental relationships mediate this disparity. Same-sex-attracted youth first demonstrated significantly higher depression symptoms at age 12 and anxiety symptoms at age 15 than exclusively other-sex-attracted youth. Age 12 peer victimization mediated the sexual orientation disparity in age 15 depression symptoms. Age 12 poor mother-child relationship mediated the sexual orientation disparity in age 15 anxiety symptoms. The findings are discussed in terms of implications for developmentally appropriate interventions against social stress during early development.

Vulnerable mothers' experience of feeding their preterm infant in neonatal care.

BackgroundWorldwide, preterm birth is a rising threat to maternal and child health. The universal challenges of being the mother of a preterm infant, combined with context-specific challenges such as poverty and poor linguistic and cultural representation, bring about risks for both mother and infant. This includes poor maternal mental health; poor mother–infant bonding and attachment and potential suboptimal developmental outcomes for the infant.ObjectiveThis article describes how Afrikaans-speaking mothers living in poverty experienced feeding their preterm infants in neonatal care.MethodThe study implemented a cross-sectional, qualitative design. Mothers of preterm infants (chronological ages between 3 and 6 months) were selected through a purposive sampling method and participated in individual semi-structured interviews. Nine interviews were thematically analysed. The participants were a vulnerable group, about whom little research literature was available.ResultsFeeding was perceived as a progressive task that worked towards the goal of discharge from the hospital. It was stressful because of various factors, but insufficient breastmilk supply was a significant contributor. The hospital setting was perceived as something that added to the participants’ anxiety surrounding feeding, but at the same time, it had the potential to decrease their anxiety. When the mother–infant dyad was able to breastfeed successfully, it made the participants feel like mothers at last after an extended period of anticipation.ConclusionFeeding their preterm infant was a prominent experience for the mothers, especially whilst in neonatal care. Increased feeding support is required from the healthcare team providing neonatal care in order to optimally use the neonatal period.

The impacts of rainfall shocks on birth weight in Vietnam

ABSTRACT This paper investigates the less discernible cost of rainfall shocks to birth weight outcomes in the context of Vietnam. Exploiting the variation across districts and conception months-years, we show that in-utero exposure to excessive and deficient rainfall shocks in the second trimester reduces child’s weight at birth by 3.5% (97 grams) and 3.1% (87 grams), respectively. Besides, infants born to poor, rural, and low-educated mothers are especially vulnerable. Since poor infant health can leave persistent effects over the life cycle, the study calls for more efforts in intervention measures to mitigate the impacts of rainfall shocks.

Armed Conflict and Child Weight in DR Congo

This paper investigates the extent to which armed conflict influences the weight of young children in the Democratic Republic of the Congo. Exploiting the variation across districts in exposure to armed conflict and the within-district variation in the timing of whether the child was exposed to armed conflict due to birth timing within a difference-in-differences framework, we detect adverse impacts of conflict exposure to child weight. Specifically, experiencing armed conflict makes children weigh less for their age and weigh less for their height by 0.20 and 0.24 standard deviations, respectively. Armed conflict also increases the probability of children being underweight and wasted by 4.7 and 2.7 percentage points, respectively. Our heterogeneity analyses reveal that children of disadvantaged backgrounds, i.e., those born to low-educated mothers, poor mothers, and rural mothers, tend to be disproportionately affected. Our study calls for effective measures to mitigate the detrimental repercussions of armed conflict.

Knowledge and Practices of Mothers about Diarrhea in Children Under Three Years Old in Heevi Pediatric Teaching Hospital in Duhok City

Background and Objectives: Diarrheal disease is the second important reason of death in children under 5 years old and is responsible for killing around 760,000 children every year. Diarrhea can last for several days and it can leave the body without the water and salts that are necessary for survival. Most people who die from diarrhea actually die from severe dehydration and fluid loss. The aim of this study is to assess the relationship between mother’s knowledge and their practice about diarrhea in children <3 years old. Research Methodology: A cross-sectional study was conducted on 50 children with diarrheal episodes attending inpatient word. A set of questionnaires from previous studies was adopted and modified to assess the relationship between mother’s knowledge and their practice about diarrhea in children less than 3 years old in Heevi Pediatric Teaching Hospital in Duhok City. Results: More than half of participants (68%) had poor knowledge, though; the 32% had good knowledge. In terms of mother’s practice, most of the participants (64%) had poor mother practice; whereas, only 36% were good mother practice. However, there was a negative correlation between mother knowledge and mother practice (P ≤ 0.001). Conclusions: The findings of the study indicate that due to lack of knowledge and poor practice about management of diarrhea the children were suffering from many complications. Relevance to clinical practice: Nurse educators have a significant role in providing health education to mothers about diarrhea in children.

Temporal trends in between and within-country inequalities in caesarean delivery in low- and middle-income countries: a Bayesian analysis.

To provide updated information about between-country variations, temporal trends and changes in inequalities within countries in caesarean delivery (CD) rates. Cross-sectional study of Demographic and Health Survey (DHS) during 1990-2018. 74 low- and middle-income countries (LMICs). Women 15-49years of age who had live births in the last 3years. Bayesian linear regression analysis was performed and absolute differences were calculated. Population-level CD by countries and sociodemographic characteristics of mothers over time. CD rates, based on the latest DHS rounds, varied substantially between the study countries, from 1.5% (95% CI 1.1-1.9%) in Madagascar to 58.9% (95% CI 56.0-61.6%) in the Dominican Republic. Of 62 LMICs with at least two surveys, 57 countries showed a rise in CD during 1990-2018, with the greatest increase in Sierra Leone (19.3%). Large variations in CD rates were observed across mother's wealth, residence, education and age, with a higher rate of CD by the richest and urban mothers. These inequalities have widened in many countries. Stratified analyses suggest greater provisioning of CD by the richest mothers in private facilities and poorest mothers in public facilities. CD rates varied substantially across geographical locations and over time, irrespective of public or private health facilities. Changes in CD rates continue across wealth, place of residence, education, and age of mother, and are widening in most study countries. Increasing caesarean delivery rates were greater among the richest and urban mothers than their counterparts, with widened gaps in LMICs.

Rural-urban differences in utilization of antenatal and delivery services in Ebonyi State, Nigeria.

The high maternal death burden in developing countries when compared to the developed could be attributed to differences in use of antenatal and skilled delivery care. To assess the differences in utilization of antenatal and delivery services in urban and rural communities of Ebonyi state, Nigeria. A cross-sectional comparative study design was used. Two stage (cluster) sampling technique was used to select 660 women in 4 of 13 local government areas in the state. The respondents were women who were permanent residents of communities and have delivered in last one year. Outcome measure was good utilization of antenatal and delivery services and was assessed by proportion of respondents who obtained antenatal and delivery from a skilled provider and also made at least four antenatal visits. The mean age of respondents was urban, 29.6 ± 6.2 and rural, 28.6 ± 5.1 years. Majority in urban, 51.8% utilized tertiary health facility for antenatal care while in rural, 77.9% used primary health centers (P < 0.001). Comparable proportions in urban, (77.3%) and rural, (79.1%) had good use of antenatal and delivery services (P = 0.572). Predictors of good use of antenatal and delivery services in urban included having one child (AOR = 4.8; 95%C1: 1.4--17.0), having attained tertiary education, (AOR = 2.6; 95%C1: 1.2--5.5), being in low socioeconomic class, (AOR = 0.4; 95%C1: 0.2--0.7), and having good knowledge of danger signs, (AOR = 2.6; 95%C1: 1.3--5.4). In rural, predictors included having one child, (AOR = 2.8; 95%C1:1.1--7.1), being unmarried, (AOR = 0.3; 95%C1: 0.1--0.9), and having good knowledge of danger signs (AOR = 3.7; 95%C1: 1.8--7.5). Utilization of antenatal and delivery services in health facilities in study area was high but there is room for improvement. There is need to plan specific interventions aimed at improving utilization of maternal health services by some groups like urban poor and unmarried mothers, especially teenagers. Emphasis should also be placed on improving community understanding of danger signs of pregnancy.

Qualitative Process Evaluation of an Agricultural Livelihood Project in Bangladesh: Multi-Sectoral Nutrition Programming Through Implementation Science

Abstract Objectives We conducted a process evaluation to examine the perceptions of program implementers, community leaders, and beneficiaries to assess the intervention's acceptability and to document how multisectoral agricultural livelihood interventions were implemented. Methods Interventions were implemented from March 2019 to March 2020 in 30 unions of three Bangladeshi districts. Delivered by community partners, interventions aimed to improve health and nutrition service utilization, social and behavior change regarding infant and young child feeding (IYCF), and homestead food production (through community farmers or private sector agro-input retailers) among poor mothers of under-two children. Leveraging the RE-AIM framework, we evaluated implementation through in-depth interviews with service providers (n = 13), focus group discussions with beneficiaries (8 sessions), and process documentation (12 events). Results Most service providers, community leaders, and beneficiaries expressed satisfaction with interventions and a desire to continue participation. Beneficiaries especially appreciated the health and nutrition education provided through different formats, including mothers' group meetings, voice messages, home visits, counseling at health facilities, and education on food production by community farmers or retailers. Additionally, beneficiaries described increased health knowledge and highly valued material benefits offered through vegetable seeds and poultry rearing inputs. Beneficiaries appreciated retailers' support to grow vegetables and raise chickens and awareness efforts on the importance of good nutrition and IYCF practices. However, findings suggested community farmers offered more interpersonal support than retailers. Service providers noted the importance of sustained community engagement. Conclusions Findings suggest that tested interventions combining food production with health and nutrition education are a viable, acceptable approach to promoting improved IYCF practices. Existing community-based organizations can reach vulnerable households with multisectoral nutrition approaches. Funding Sources United States Agency for International Development (USAID).

Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data

BackgroundReducing poverty and improving access to health care are two of the most effective actions to decrease maternal mortality, and conditional cash transfer (CCT) programmes act on both. The aim of this study was to evaluate the effects of one of the world’s largest CCT (the Brazilian Bolsa Familia Programme (BFP)) on maternal mortality during a period of 11 years.MethodsThe study had an ecological longitudinal design and used all 2548 Brazilian municipalities with vital statistics of adequate quality during 2004–2014. BFP municipal coverage was classified into four levels, from low to consolidated, and its duration effects were measured using the average municipal coverage of previous years. We used negative binomial multivariable regression models with fixed-effects specifications, adjusted for all relevant demographic, socioeconomic, and healthcare variables.ResultsBFP was significantly associated with reductions of maternal mortality proportionally to its levels of coverage and years of implementation, with a rate ratio (RR) reaching 0.88 (95%CI 0.81–0.95), 0.84 (0.75–0.96) and 0.83 (0.71–0.99) for intermediate, high and consolidated BFP coverage over the previous 11 years. The BFP duration effect was stronger among young mothers (RR 0.77; 95%CI 0.67–0.96). BFP was also associated with reductions in the proportion of pregnant women with no prenatal visits (RR 0.73; 95%CI 0.69–0.77), reductions in hospital case-fatality rate for delivery (RR 0.78; 95%CI 0.66–0.94) and increases in the proportion of deliveries in hospital (RR 1.05; 95%CI 1.04–1.07).ConclusionOur findings show that a consolidated and durable CCT coverage could decrease maternal mortality, and these long-term effects are stronger among poor mothers exposed to CCT during their childhood and adolescence, suggesting a CCT inter-generational effect. Sustained CCT coverage could reduce health inequalities and contribute to the achievement of the Sustainable Development Goal 3.1, and should be preserved during the current global economic crisis due to the COVID-19 pandemic.

Mother-infant bonding screening in a sample of postpartum women: comparison between online vs offline format

ABSTRACT Aims We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). Methods A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. Results The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. Conclusion Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method.