College of Nursing, The Pennsylvania State University, 90 Hope Drive, Hershey, PA 17033, USA.
BMC Womens Health. 2014 Jul 15;14:83. doi: 10.1186/1472-6874-14-83.
Miscarriage, the unexpected loss of pregnancy before 20 weeks gestation, may have a negative effect on a mother's perception of herself as a capable woman and on her emotional health when she is pregnant again subsequent to the miscarriage. As such, a mother with a history of miscarriage may be at greater risk for difficulties navigating the process of becoming a mother and achieving positive maternal-infant bonding with an infant born subsequent to the loss. The aim of this study was to examine the effect of miscarriage history on maternal-infant bonding after the birth of a healthy infant to test the hypothesis that women with a history of miscarriage have decreased maternal-infant bonding compared to women without a history of miscarriage.
We completed secondary analysis of the First Baby Study, a longitudinal cohort study, to examine the effect of a history of miscarriage on maternal-infant bonding at 1 month, 6 months, and 12 months after women experienced the birth of their first live-born baby. In a sample of 2798 women living in Pennsylvania, USA, we tested our hypothesis using linear regression analysis of Shortened Postpartum Bonding Questionnaire (S-PBQ) scores, followed by longitudinal analysis using a generalized estimating equations model with repeated measures.
We found that women with a history of miscarriage had similar S-PBQ scores as women without a history of miscarriage at each of the three postpartum time points. Likewise, longitudinal analysis revealed no difference in the pattern of maternal-infant bonding scores between women with and without a history of miscarriage.
Women in the First Baby Study with a history of miscarriage did not differ from women without a history of miscarriage in their reported level of bonding with their subsequently born infants. It is important for clinicians to recognize that even though some women may experience impaired bonding related to a history of miscarriage, the majority of women form a healthy bond with their infant despite this history.
流产,即妊娠 20 周前意外终止,可能会对母亲作为有能力的女性的自我认知以及其再次怀孕时的情绪健康产生负面影响。因此,有过流产史的母亲在再次怀孕时,可能更难以顺利地成为母亲,与随后出生的婴儿建立积极的母婴关系。本研究旨在探讨流产史对产后健康婴儿母婴关系的影响,以检验以下假设:与无流产史的女性相比,有流产史的女性母婴关系较差。
我们对纵向队列研究“第一个宝宝研究”进行二次分析,以检验流产史对女性分娩后第一个活产婴儿 1 个月、6 个月和 12 个月时母婴关系的影响。在美国宾夕法尼亚州的 2798 名女性中,我们使用缩短产后母婴关系问卷(S-PBQ)评分的线性回归分析来检验我们的假设,随后使用具有重复测量的广义估计方程模型进行纵向分析。
我们发现,在三个产后时间点,有流产史的女性与无流产史的女性的 S-PBQ 评分相似。同样,纵向分析显示,有和无流产史的女性母婴关系评分模式没有差异。
“第一个宝宝研究”中的有流产史的女性与无流产史的女性在报告的与随后出生婴儿的联系程度上没有差异。临床医生应该认识到,尽管一些女性可能会因流产史而出现母婴联系受损,但大多数女性仍会与婴儿建立健康的联系。