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择期剖宫产和急诊剖宫产对母亲情绪及母婴情感联结的影响。

Influence of elective and emergency cesarean delivery on mother emotions and bonding.

作者信息

Zanardo Vincenzo, Soldera Gino, Volpe Francesca, Giliberti Lara, Parotto Matteo, Giustardi Arturo, Straface Gianluca

机构信息

Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.

Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.

出版信息

Early Hum Dev. 2016 Aug;99:17-20. doi: 10.1016/j.earlhumdev.2016.05.006. Epub 2016 Jul 2.

DOI:10.1016/j.earlhumdev.2016.05.006
PMID:27380109
Abstract

BACKGROUND

Previous studies have indicated that mode of delivery could have a negative effect on bonding.

AIMS

To assess feelings towards newborn infants in mothers who delivered by cesarean delivery, elective (ElCD) or emergency (EmCD).

STUDY DESIGN

This observational prospective study took place at the Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy, from September 2014 to April 2015.

SUBJECTS

The sample included 573 puerperae divided into three groups: women undergone ElCD (n=73; 12.73%), women undergone EmCD (n=81; 14.13%) and women who underwent vaginal delivery (VD) (n=419; 73.12%).

OUTCOME MEASURES

The instrument used was the Mother-to-Infant Bonding Scale (MIBS; Taylor et al., 2005), a self-report test to measure mother's feelings towards her baby. High scores indicate worse mother-to-infant bonding and a score≥2, established as cut-off, indicates an altered bonding.

RESULTS

The mean MIBS global score was 0.50±1.05 in the VD mothers, 0.67 (±1.14) for ElCD mothers and 0.92 (±1.05) for EmCD mothers, resulting significantly higher in EmCD mothers (p<0.001). The percentage of altered bonding (Score≥2) in the three groups was of 11.21% (n=47) in VD, 17.80% (n=13) in ElCD and 23.45% (n=19) in EmCD, significantly higher in EmCD women (p<0.006). In addition, EmCD mothers scored significantly higher Joyful (0.074±0.26 vs 0.185±0.39; p<0.005) and Disappointed (0.063±0.25 vs 0.123±0.36; p<0.008) subscales.

CONCLUSIONS

It was found that EmCD negatively affects mother bonding and opening emotions, and originates in mother feelings like sadness and disappointment for the unplanned delivery evolution.

摘要

背景

先前的研究表明分娩方式可能对母婴情感联结产生负面影响。

目的

评估剖宫产分娩(择期剖宫产或急诊剖宫产)的母亲对新生儿的情感。

研究设计

这项观察性前瞻性研究于2014年9月至2015年4月在意大利阿巴诺泰尔梅市阿巴诺泰尔梅综合医院围产医学科进行。

研究对象

样本包括573名产妇,分为三组:接受择期剖宫产的女性(n = 73;12.73%)、接受急诊剖宫产的女性(n = 81;14.13%)和经阴道分娩的女性(n = 419;73.12%)。

观察指标

使用的工具是母婴情感联结量表(MIBS;Taylor等人,2005年),这是一项自我报告测试,用于测量母亲对其婴儿的情感。高分表明母婴情感联结较差,设定的临界值为得分≥2分,表示情感联结异常。

结果

经阴道分娩的母亲的MIBS总体平均得分为0.50±1.05,择期剖宫产母亲为0.67(±1.14),急诊剖宫产母亲为0.92(±1.05),急诊剖宫产母亲的得分显著更高(p<0.001)。三组中情感联结异常(得分≥2分)的比例在经阴道分娩组为11.21%(n = 47),择期剖宫产组为17.80%(n = 13),急诊剖宫产组为23.45%(n = 19),急诊剖宫产组女性的比例显著更高(p<0.006)。此外,急诊剖宫产母亲在“愉悦”(0.074±0.26对0.185±0.39;p<0.005)和“失望”(0.063±0.25对0.123±0.36;p<0.008)子量表上的得分显著更高。

结论

研究发现急诊剖宫产对母婴情感联结和情感开放有负面影响,其源于母亲对意外分娩过程的悲伤和失望等情感。

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