Postpartum Bonding Questionnaire Research Articles

The NIMHANS (National Institute of Mental Health and Neuro Sciences) Maternal Behaviour Scale (NIMBUS): Development and validation of a scale for assessment of maternal behaviour among mothers with postpartum severe mental illness in low resource settings

A mother's behaviour towards her infant is an important aspect of assessment in postpartum severe mental illness (SMI). The existing tools for this purpose need formal training, require time and do not include certain aspects of maternal behaviour. Hence, there is a need for a tool that may overcome some of the above problems and be simple to use, especially in limited resource low and middle income countries (LAMIC) settings. The NIMHANS Maternal Behaviour Scale was constructed for this purpose. The 16 items were compiled based on 100 detailed assessments of mother-infant dyads. The NIMBUS is rated based on observations and information from caregivers, health assistants and nurses. The scale which has six domains was administered to 51 mother-infant dyads admitted to an MBU to establish construct validity and internal consistency. Inter-rater, and test retest reliability were also established. External validity was established using the Bethlem Mother infant Interaction Scale (BMIS) and the Postpartum Bonding Questionnaire (PBQ). The scale was found to have adequate inter-rater and test retest reliability (Cohen's kappa > 0.81). The Cronbach's alpha for internal consistency was 0.94 and it showed adequate external validity when used with the BMIS (R = 0.947, p = 0.000) and PBQ. The NIMBUS appears to be a useful tool to assess maternal behaviour among mothers with SMI in the postpartum especially in LAMIC situations where observations are often made by family members and health assistants rather than trained perinatal nurses.

Postpartum-specific anxiety and maternal bonding: Further evidence to support the use of childbearing specific mood tools

ABSTRACT Background: Research examining the relationship between postpartum anxiety and maternal bonding is limited by the use of general measures of anxiety which may predict perinatal outcomes less effectively than childbearing specific tools. Objectives: This study aimed to investigate the predictive validity of the Postpartum Specific Anxiety Scale [PSAS] and examine whether it is a more effective predictor of maternal bonding than general measures of anxiety. Methods: Two hundred and sixty one mothers (≤6-months postpartum) completed the PSAS alongside general anxiety and depression measures. Maternal bonding was examined via the Postpartum Bonding Questionnaire [PBQ] two-weeks later. Results: Hierarchical regression models demonstrated that higher levels of postpartum specific anxiety were associated with impaired overall bonding scores, and subscales of impaired general bond, rejection and anger, and infant focused anxieties. As hypothesised, the PSAS predicted unique variance in maternal bonding in these domains after controlling for general measures of anxiety and depression. Conclusion: These findings provide further evidence to support the predictive utility of the PSAS and the use of childbearing-specific measures of mood when predicting perinatal outcomes.

Maternal personality traits, antenatal depressive symptoms and the\xa0postpartum\xa0mother\u2013infant relationship: a prospective observational study

PurposeMaternal depression has been associated with bonding difficulties and lower maternal sensitivity in observed mother–infant interactions. However, little research has examined the impact of disordered personality traits in mothers on these outcomes. We investigated the association between disordered personality traits in mothers measured during pregnancy and postnatal (a) self-reported bonding with infant; (b) observational mother–infant interactions.MethodsFive hundred fifty-six women were recruited during early pregnancy and subsequently followed up at mid-pregnancy (approximately 28 weeks’ gestation) and when infants were aged approximately 3 months (n = 459). During early pregnancy, data were collected on disordered personality traits (using the Standardised Assessment of Personality Abbreviated Scale) and depressive symptoms (using the Edinburgh Postnatal Depression Scale). At 3 months postpartum, self-reported perceived bonding (using the Postpartum Bonding Questionnaire) were collected. A sub-sample of women additionally provided observational mother–infant interaction data (n = 206) (coded using the Child–Adult Relationship Experimental Index).ResultsHigher disordered personality traits was not associated with maternal perceptions of bonding impairment, but was associated with reduced maternal sensitivity during observational mother–infant interactions [adjusted for age, education, having older children, substance misuse prior to pregnancy, infant sex and gestational age: coefficient = − 0.28, 95% CI = − 0.56 to − 0.00, p < 0.05]. After adjusting for depressive symptoms, the association was attenuated [coefficient = − 0.19, 95% CI = − 0.48 to 0.11, p = 0.217].ConclusionsMothers with disordered personality traits did not perceive themselves as having bonding impairments with their infants but were less sensitive during observed interactions, though depressive symptoms attenuated this relationship. Both depression and disordered personality traits need to be addressed to optimize mother–infant interactions.

The Impact of Chronic Periodontitis on Mother-Infant Bonding Status in Relation to Salivary Tumor Necrosis Factor Alpha and Interleukin-6

Background: Chronic periodontitis is a bacterial infection that result in bone destruction associated with the increasing level of salivary tumor necrosis alpha and interleukin6 that affect Mother-infant bonding status. The aim of the present study was to assess the relationship between the Mother-infant bonding status in mothers with chronic periodontitis in relation to Salivary Tumor necrosis factor alpha and Salivary Interleukin6. Materials and Methods: The selected sample consisted of mothers with chronic periodontitis compared with mothers with healthy periodontium in postpartum period, their age ranged between 30-40 years. Both groups were subjected to postpartum Bonding Questionnaire (PBQ). Periodontal health status was assessed for control group like plaque index and gingival index in order to obtain control group with healthy periodontium, while measuring probing pocket depth and clinical attachment level in addition to plaque and gingival index for study group. Salivary Tumor necrosis factor alpha and Interleukin6 measure in saliva by enzyme-linked immune sorbent assay (ELISA). Results: The mean values of Salivary Tumor necrosis factor alpha and Interleukin 6 were found to be higher among mothers with chronic periodontitis than mothers with normal bonding relationship, and the percentage of disorder mother-infant bonding relation was higher in study group than in control group. Conclusion: Mother-infant bondings affected by chronic periodontitis as the patient have higher Salivary Tumor necrosis factor alpha and Salivary Interleukin6 than mothers with healthy periodontal condition.

The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality

IntroductionPrenatal maternal anxiety disorders have been associated with adverse outcomes in offspring including emotional, behavioral and cognitive problems. There is limited understanding of the mechanisms underpinning these associations, although one possible candidate is an impaired mother-infant relationship. The authors investigated whether prenatal anxiety disorders were associated with poorer postpartum mother-infant relationship quality, measured by maternal self-reported bonding and observed mother-infant interactions. MethodsA cohort of 454 pregnant women recruited from an inner-city maternity service in London (UK) were assessed for mental disorders using the Structured Clinical Interview for DSM-IV and followed up at mid-pregnancy and 3-months postpartum. Depressive symptoms were assessed at baseline and mid-pregnancy (using the Edinburgh Postnatal Depression Scale). At three months postpartum, women were assessed for self-reported bonding difficulties (using the Postpartum Bonding Questionnaire) and a subsample (n = 204) participated in video-recorded mother-infant interaction, coded using the Child-Adult Relationship Experimental Index by an independent rater. ResultsPrenatal anxiety disorders were associated with higher perceived bonding impairment, but not associated with observed poor mother-infant interaction quality. Higher levels of depressive symptoms were associated with lower maternal sensitivity. ConclusionsInterventions for anxiety disorders in the perinatal period could be tailored to address anxieties about mother-infant relationship and co-morbid depressive symptoms.

Postpartum bonding at the beginning of the second year of child’s life: the role of postpartum depression and early bonding impairment

Background: We evaluated the association between mother–child bonding and maternal depression at 6–8 months after birth with bonding impairment at 12–15 months in a sample of mothers at high risk of postnatal depression.Methods: A prospective cohort study with 346 low-income postpartum women with antenatal depression. The Postpartum Bonding Questionnaire (PBQ) and the Patient Health Questionnaire-9 (PHQ-9) were used, at 6–8 and 12–15 months after delivery, to assess the mother–infant bonding and postnatal depression (PPD), respectively.Results: The percentage of the main outcome, bonding impairment (BI) at 12–15 months, was 9.9% (95% CI 6.6–13.7). Using logistic regression models, BI was associated with: having an occupation (OR = 2.82; 95% CI 1.00–7.94, p = .049), unplanned pregnancy (OR = 3.46; 95% CI 1.01–11.8, p = .047), and presence of BI at 6–8 months (OR= 13.0; 95% CI 3.76–45.4, p ≤ .001). Maternal depression was marginally associated with BI at 12–15 months.Conclusions: BI affects 1 in 10 mothers, and although BI and PPD are strongly associated at 6–8 and 12–15 months after delivery, BI at 6–8 months is the main predictor of later BI. Based on the study findings, PPD screening in combination with BI assessment is highly recommended during the first year of child’s life.

Associations of postpartum mother-infant bonding with maternal childhood maltreatment and postpartum mental health: a cross-sectional study

BackgroundAfter delivery, some women experience impairment of their mother-infant bonding (MIB), which can lead to long-term disturbances of the mother-child relationship and the child’s social-emotional development. Little is known about the association between early maternal bonding problems and mothers’ own adverse childhood experiences, even though the hypothesis of the intergenerational transmission of caregiving indicates continuity in parenting quality across generations. Therefore, the current study aimed at examining the relationship between maternal childhood maltreatment and postpartum MIB, controlling for the role of postpartum mental health.MethodsFrom February 2014 to March 2015, 725 women completed self-report measures 2 months postpartum. Maternal childhood maltreatment was assessed with the Childhood Trauma Questionnaire, postpartum depression with the Revised Beck Depression Inventory, postpartum anxiety with the Symptom Checklist-90-Revised, and postpartum MIB with the abridged version of the Postpartum Bonding Questionnaire. Data were analysed using a hierarchical regression analysis.ResultsAlmost 46% of the included women reported at least one type of childhood maltreatment with emotional neglect being most prevalent. 13% displayed at least mild postpartum depressive symptomatology and 20% scored above the 75th percentile for postpartum anxiety. In the final regression model, which explained 29% of variance, higher severity of maternal emotional neglect in childhood, higher levels of postpartum depression and higher education were significantly related to more postpartum MIB impairment. In contrast, higher severity of maternal physical neglect was significantly associated with less postpartum MIB impairment.ConclusionsThis study is the first to explore the relationship between diverse types of maternal childhood maltreatment and postpartum MIB, adjusting for postpartum mental health. Maternal experiences of emotional neglect and postpartum depressive symptoms could serve as indicators to identify and support mothers with heightened risk for bonding problems, but results need to be validated in longitudinal studies.

Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial

IntroductionPreterm birth has major medical, psychological and socioeconomic consequences worldwide. Music therapy (MT) has positive effects on physiological measures of preterm infants and maternal anxiety, but rigorous studies including long-term...

Early postpartum resting-state functional connectivity for mothers receiving buprenorphine treatment for opioid use disorder: A pilot study.

Between 1999 and 2014, the prevalence of opioid use disorder (OUD) among pregnant women quadrupled in the USA. The standard treatment for peripartum women with OUD is buprenorphine. However, the maternal behavior neurocircuit that regulates maternal behavior and mother-infant bonding has not been previously studied for human mothers receiving buprenorphine treatment for OUD (BT). Rodent research shows opioid effects on reciprocal inhibition between maternal care and defence maternal brain subsystems: the hypothalamus and periaqueductal gray, respectively. We conducted a longitudinal functional magnetic resonance imaging (fMRI) pilot study in humans to specifically examine resting-state functional connectivity (rs-FC) between the periaqueductal gray and hypothalamus, as well as to explore associations with maternal bonding for BT. We studied 32 mothers who completed fMRI scans at 1month (T1) and 4months postpartum (T2), including seven mothers receiving buprenorphine for OUD and 25 non-OUD mothers as a comparison group (CG). The participants underwent a 6-minute resting-state fMRI scan at each time point. We measured potential bonding impairments using the Postpartum Bonding Questionnaire to explore how rs-FC with periaqueductal gray is associated with bonding impairments. Compared to CG, BT mothers differed in periaqueductal gray-dependent rs-FC with the hypothalamus, amygdala, insular cortex and other brain regions at T1, with many of these differences disappearing at T2, suggesting potential therapeutic effects of continuing buprenorphine treatment. In contrast, the "rejection and pathological anger" subscale of the Postpartum Bonding Questionnaire at T1 and T2 was associated with the T1-to-T2 increases in periaqueductal gray-dependent rs-FC with the hypothalamus and amygdala. Preliminary evidence links maternal bonding problems for mothers with OUD early in the postpartum to connectivity between specific care and defence maternal brain circuits, which may be mitigated by buprenorphine treatment. This exploratory study supports a potential mechanism for investigating both the therapeutic benefits and risks of opioids for maternal care and bonding with infants.

C-48 Attachment and SES at Newborn, Two, and Four Months Related to Communication Development at Nine and Twelve Months

Abstract Objective Previous literature linked secure infant attachment to subsequent communication competency (Murray &amp; Yingling, 2000). Less is known about that relationship in families of varying SES. This study explores how attachment and income at newborn, two, and four months correspond with communication development at nine and twelve months. Methods Longitudinal (n = 30) and cross-sectional (n = 102) reports from PediaTrac□, a parent-report web-based survey to track development (Lajiness-O’Neill, et al., 2018), were collected at newborn (NB; n = 41), two (2m; n = 38), four (4m; n = 37), nine (9m; n = 38), and twelve months (12m; n = 36). The cross-sectional sample had higher income (p = .01). Attachment was measured using PediaTrac□ and the Postpartum Bonding Questionnaire (PBQ; Brockington, Fraser &amp; Wilson, 2006). Communication was measured using PediaTrac□. Results A linear regression model predicted communication development at 9m and 12m from attachment and income at NB, 2m, and 4m. PBQ attachment at 2m significantly predicted communication at 9m (b = 0.12, t = 2.28, p = .049). However, income was not significant, and neither attachment nor income at NB, 2m, or 4m predicted communication at 12m. Conclusions More secure attachment at two months was related to better communication outcomes at nine months regardless of SES. This finding highlights the importance of parent-infant relationships at two months of age on development, indicating further research on methods to promote secure attachment and positive parent-infant interaction in families of varying SES.

Assessment of Psychometric Properties of the Postpartum Bonding Questionnaire (PBQ) in Jordanian Mothers

Background: Mother to infant bonding is the most important process in the puerperium, where many instruments have been designed to screen for mother-infant bonding issues. In this study, we will translate and validate the Postpartum Bonding Questionnaire (PBQ) to the Arabic and to measure the mother-infant bonding in a sample of Jordanian mothers.Materials and methods: This sample is a representative sample taken from multiple centers in Amman, Jordan. Post-partum lady who give a birth to a live healthy baby, regardless the mood of the delivery, who have been discharged with their babies home. Women with multiple pregnancies were also included. We calculated reliability indices and relevant statistics using SPSS.Results: A total of 120 participants included in this study. The mean age for the included sample was 28.1 (±6.3) years. Scale internal consistency measured via Cronbach’s alpha is 0.720. Average intraclass correlation coefficient for single measure is 0.067 (CI 0.045 to 0.097). Mean score for the 4 factors of the questionnaire were: Factor 1: 17.43 (±3.95), factor 2: 4.10 (±3.98), factor 3: 7.99 (±2.39), factor 4: 0.37 (±0.94).Conclusion: We translated and validated an Arabic version of the Postpartum Bonding Questionnaire (PBQ), an easy and widely used instrument to measure mother-infant bonding disorders. We observed a high frequency of bonding disorder among a Jordanian sample.

Frequency and correlates of mother-infant bonding disorders among postpartum women in India.

Disorders of mother-infant bonding have been described since early 20th Century. Previous studies have looked at the prevalence of bonding disorders among mothers with postpartum psychiatric disorders. However, its frequency among healthy postpartum mothers is less studied. Two hundred and fifty mother-infant dyads were studied using the Mini International Neuropsychiatric Interview (MINI), the Stafford Interview, Bangalore Maternal Behaviour Scale (BMBS) and Tamil versions of the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Questionnaire (PBQ). The mothers were interviewed between 4 weeks to six months postpartum. In addition, thirty one mothers with a lifetime history of psychiatric disorders were interviewed using the above scales. The frequency of bonding disorders was found to be 24% among healthy postpartum mothers as against 45.2% in mothers with psychiatric disorder. However, the frequency of mild disorders of bonding was relatively lower at 5.6% among healthy mothers and 6.5% among mothers with psychiatric disorders. We found that mothers in India had a clinging / over-involved subtype of anxiety that prevented them from leaving their baby under care of another competent adult. While infant-related anxiety was seen in 10% of healthy mothers, about 20% of mothers with psychiatric diagnoses had anxiety. The presence of bonding disorders was not correlated with any maternal or infant related factors except difficulty in breastfeeding. Disorders of mother infant bonding are seen in healthy postpartum mothers. The frequency of mild disorders of bonding appears to be similar across countries and this condition warrants further attention.

Mother-infant bonding is not associated with feeding type: a community study sample

BackgroundBonding refers to emotions and cognitions towards one’s infant. Breastfeeding is believed to facilitate bonding, yet only a handful of studies have empirically tested this assertion. This study aimed to confirm whether a positive association between breastfeeding and bonding exists and whether breastfeeding may be protective against the negative consequences of mood and sleep disturbances on bonding.MethodA cross-sectional survey was administered to a convenience sample of Israeli mothers of infants ages 1–9 months. The main outcome measures were breastfeeding history, bonding (Postpartum Bonding Questionnaire, PBQ), mood (Edinburgh Postnatal Depression Scale, EPDS) and sleep (Pittsburgh Sleep Quality Index, PSQI).ResultsTwo hundred seventy-one mothers (21–46 years) completed the survey. 65.7% reported current breastfeeding, 22.1% past breastfeeding, 12.2% never nursed. The PBQ correlated with both the EPDS and PSQI. Breastfeeding was associated with greater daytime fatigue, but not with any other sleep problem, and was not associated with bonding. This negative result was confirmed with Bayesian analysis demonstrating that the probability for the null hypothesis was 4.5 times greater than the hypothesized effect. Further, hierarchical regression revealed a positive relationship between bonding, daytime fatigue and depression symptoms only among women who were currently breastfeeding.ConclusionsThese findings suggest that among healthy mothers, breastfeeding may not be a central factor in mother-infant bonding, nor is it protective against the negative impact of mood symptoms and bonding difficulties. Theoretical and methodological bases of these findings are discussed.

Factorial Structures of Postpartum Bonding Questionnaire (PBQ): A Systematic Review

Background Postpartum Bonding Questionnaire (PBQ) is a remarkable tool to assess impairments in the mother-infant bonding. The purpose of the present study was to review the factorial structure of the PBQ cross different versions. Materials Methods The search strategy was implemented on databases of Medline (via PubMed), Scopus, Cochran library Web of Science through electronic databases. The quality assessment was fulfilled by COSMIN checklist. Results: The four factors were identified in original English version of PBQ. Theses consisted of impaired bounding, anger, anxiety about care of the baby, of abuse. Three-factor-solution was confirmed by other English versions. In the Italian version of PBQ, three factors emerged including toward the infant, detachment anxiety about infant care. In the Spanish version of the PBQ, four factors including impaired bonding, anxiety about care, lack of enjoyment for the baby, risk of abuse. Three studies assessed factorial structure of Japanese version of PBQ. In the first Japanese version, four factors with 14 items were emerged including impaired bonding , anger anxiety about care, lack of affection. In second adapted Japanese version, exploratory factor analysis (EFA) identified a three factor solution: mother's annoyance with toward their baby, lack of affection and rejection fear. The third version identified one-single solution. In the German version, one single factor emerged that explained 31 of the total variance. Conclusion Original English version of PBQ was not confirmed in Japanese, Italian, Spanish other English versions.

Risk factors for impaired maternal bonding when infants are 3\u2009months old: a longitudinal population based study from Japan

BackgroundImpaired maternal bonding has been associated with antenatal and postnatal factors, especially postpartum depression. Only a few population-based, longitudinal studies have examined the association between maternal depression and bonding in outside western countries. In addition, little is known about the association between psychosocial factors during pregnancy and impaired maternal bonding. The aim of this study was to investigate risk factors associated with impaired maternal bonding 3 months after delivery using Japanese population-based, longitudinal study from pregnancy period to 3 months after delivery.MethodsThis study was performed at the public health care center in Hekinan city, Aichi prefecture, Japan. Mothers who participated the infant’s health check-up 3 months after delivery from July 2013 to Jun 2015 completed the Postpartum Bonding Questionnaire (PBQ) and the Edinburgh Postnatal Depression Scale (EPDS) 1 month after delivery. Information was also provided from home visit at 1 month after delivery, birth registration form, and pregnancy notification form. The study included 1060 mothers with a mean age of 29.90 years, who had given birth at a mean of 38.95 weeks.ResultsBivariate and multivariate logistic regression analyses were conducted to identify the association between antenatal and postnatal factors and impaired maternal bonding. The main findings were that maternal negative feelings about pregnancy (OR = 2.16, 95% CI = 1.02–4.56) and postpartum depression at 1 month after delivery (OR = 7.85, 95% CI = 3.44–17.90) were associated with higher levels of impaired maternal bonding 1 months after delivery. Mothers who had delivered their first child had increased odds of a moderate level of impaired maternal bonding 3 months after delivery (OR = 1.85, 95% CI = 1.22–2.81).ConclusionsThe findings emphasize the importance of identifying mothers with depression and those with maternal negative feelings towards pregnancy to assess possible impaired maternal bonding.

Translation, validation and factor structure of the Tamil version of the Postpartum Bonding Questionnaire (PBQ-T).

The Postpartum Bonding Questionnaire was developed in English for the purpose of screening for bonding disorders among postpartum mothers. There was a felt need for a Tamil translation of the self-rated instrument. The Postpartum Bonding Questionnaire was translated into Tamil (PBQ-T). Two hundred and fifty mother-infant dyads were administered the PBQ-T along with the Stafford Interview. The Stafford Interview was studied by two independent psychiatrists to arrive at a diagnosis of bonding disorders in the mothers. The Edinburgh Postnatal Depression Scale (EPDS) and Bangalore Maternal Behaviour Scale (BMBS) were used for rating depressive symptoms and caregiver reported behaviour of the mother towards the infant. We also did a factor analysis to find the factor structure of the PBQ-T. A 19-item PBQ-T that has five factors grouped into three subscales. The five factors are General Bonding (F1A), Frustration (F1B), Anxiety (F2), Feeling trapped (F3A) and Aggression/ Rejection dimensions (F3B) loading onto three subscales 1, 2 and 3. Total PBQ-T scores were best used to detect 'any disorder of bonding' (cut-off 5/6). Subscale 1 (cut-off 2/3) was useful in detection of mild disorders of bonding, subscale 2 (cut-off 2/3) for infant-focused anxiety and subscale 3 (cut-off 0/1) for Anger/ Rejection. Mothers with bonding disorders had greater psychological distress. Caregiver report of mother's behaviour (BMBS) could detect anxiety and anger/ rejection but not the lack of emotional bond. A 19-item Tamil version of the PBQ is useful in screening for disorders of mother-infant bonding among healthy postpartum mothers.

Pre-conception self-harm, maternal mental health and mother-infant bonding problems: a 20-year prospective cohort study.

Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother-infant bonding problems. The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3-9. VIHCS enrolment began in 2006 (when participants were aged 28-29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother-infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum. Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20-29) reported higher levels of perinatal depressive symptoms and mother-infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42-7.39; mother-infant bonding problems adjusted β = 7.51, 95% CI 3.09-11.92]. There was no evidence that self-harm in adolescence (ages 15-17) was associated with either perinatal outcome. Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother-infant bonding problems.

Investigating the Effect of Counseling Based on Family Support on Mother-Child Bonding at 4-6 Weeks of Postpartum in Primiparous Women: A Randomized Clinical Trial

Background Emotional bonding between mother and neonate is an extremely sensitive process in postpartum. Therefore, one of the important processes in the postpartum period is the development of maternal and neonatal bonding. This study was aimed to investigate the effect of family-based counseling on mother-child bonding at 4-6 weeks of postpartum in women referred to selected health centers of Urmia in 2017. Materials and Methods This clinical trial study was conducted on 330 women and their families who were selected in health care centers of Urmia in 2017. Data collection tools were personal information form, General Health Questionnaire (GHQ), Multidimensional Scale of Perceived Social Support (MSPSS), and Postpartum Bonding Questionnaire. The women were randomly divided into two groups: intervention (n = 165) and control (n =165). The intervention group received 4-6 counseling sessions based on family support and the control group received routine care. Data analysis was performed using SPSS software (version 20), non-parametric Mann-Whitney test, Wilcoxon and parametric t tests. P value less than 0.05 was considered significant. Results Findings revealed a significant reduction in mean ± SD of total mother-child bonding (41.17± 33.37), general bonding difficulties (19.17± 18.04), threatened rejection (11.95±9.86), infant-focused anxiety (6.77± 5.70) and incipient abuse (3.27± 2.90). Conclusion According to the obtained results, family-based counseling has deeply positive effect on mother-child bonding that can arise physical and mental health benefits originated from this bonding in childhood period and in all stage of puberty.

Transcultural adaptation to the Brazilian Portuguese of the Postpartum Bonding Questionnaire for assessing the postpartum bond between mother and baby.

The establishment of the bond between mother and baby in the postpartum period is important for ensuring the physical and psychological health of both. This short communication reports the first phase of the cross-cultural translation and adaptation to the Brazilian context of the Postpartum Bonding Questionnaire (PBQ). Four aspects of equivalence between the original scale and the Portuguese version were evaluated: the conceptual, semantic, operational and item equivalences. Literature review, the study of PBQ history, translation, expert evaluation, back-translation and pretests involving 30 mothers with children aging up to 7 months using a primary healthcare unit were conducted. Each step demonstrated the need for adjustments, which were made during the adaptation process. At the end of the study, a version of PBQ in Brazilian Portuguese equivalent to the original one was obtained, offering promise for national studies on the mother-baby bond, and its influence on health, and for use in health services.

Is the Effect of Postpartum Depression on Mother-Infant Bonding Universal?

PurposeAlthough the negative consequences of maternal depression on infants has been documented in several Western societies, similar studies have not been conducted in Middle-Eastern countries where cultural norms and traditions may differ. The main objective of this study was to determine the risk factors for postpartum depression (PPD) and its relationship to mother −infant bonding in a Lebanese population. MethodsOne hundred and fifty participants were administered the Edinburgh Postpartum Depression Scale (EPDS), and the social support scale at 2–3 days postpartum. At 10–12 weeks mother–infant bonding using the Postpartum Bonding Questionnaire (PBQ) and depression using the Beck Inventory (BDI-II) were assessed during a telephone interview. ResultsThe prevalence of depression was 19% with an average score of 10.9 ± 6.02 on the EPDS. At 10–12 weeks 2.7% of the whole sample was depressed with an average score of 18.60 ± 16.87 on the BDI-II. Risk factors of PPD on the EPDS were; history of alcohol use, complications during pregnancy, not a good marital relationship, baby admitted to an intensive care unit, history of depression and low social support. Risk factors for impaired bonding were age, history of depression, BDI-II scores above 20 and low social support. The multiple regression analysis found that impaired bonding was associated with older age, history of depression and low social support, which explained 39% of the variance, F = 7.12, p = 0.02. ConclusionThe prevalence of PPD was higher than previously reported at day 2–3 post-delivery, but lower at 10–12 weeks postpartum. Impaired mother- infant bonding was associated older mothers, history of depression, low social support and BDI-II scores above 20 which should alert practitioner to assessing these factors in post-partum mothers.