Borghini Ayala, Pierrehumbert Blaise, Miljkovitch Raphaële, Muller-Nix Carole, Forcada-Guex Margarita, Ansermet François
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne.
University Paris X, France.
Infant Ment Health J. 2006 Sep;27(5):494-508. doi: 10.1002/imhj.20103.
The effects of premature birth on attachment have generally been examined from the infant's perspective. There is a lack of data concerning parental attachment representations toward a premature child. Because of the psychological stress engendered in parents confronted with a premature birth, we hypothesized that their attachment representations would be altered during the first months after the hospital discharge. Fifty families with a premature infant (25-33 gestation weeks) and a control group of 30 families with a full-term infant participated to the study. Perinatal risks were evaluated during hospitalization. To assess mothers' representations of their infant, the Working Model of the Child Interview (WMCI, Zeanah & Benoit, 1995 & Benoit, Zeanah, Parker, Nicholson, & Coolbear, 1997) were administered when their children were 6 and 18 months old. The severity of the perinatal risks was found to have an impact on the mothers' attachment representations. At six months, only 20% of the mothers of a prematurely born infant (30% at 18 months) had secure attachment representations, vs. 53% for the control group (57% at 18 months). Furthermore, mothers of low-risk premature infants more often had disengaged representations, whereas distorted representations were more frequent in the high-risk group of premature children. These findings suggest that the parental response to a premature birth is linked to the severity of postnatal risks. The fact that secure attachment representations are affected in mothers of low-risk infants just as much as they are in mothers of high-risk infants points to the need to conduct further studies aimed at evaluating whether preventive intervention for both low-risk and high-risk premature will be helpful.
早产对依恋关系的影响通常是从婴儿的角度进行研究的。目前缺乏关于父母对早产孩子依恋表征的数据。由于父母面对早产时会产生心理压力，我们推测他们的依恋表征在孩子出院后的头几个月会发生变化。五十个有早产婴儿（孕龄25 - 33周）的家庭和三十个有足月儿的对照组家庭参与了这项研究。住院期间评估了围产期风险。为了评估母亲对其婴儿的表征，当孩子6个月和18个月大时，采用了儿童访谈工作模型（WMCI，Zeanah & Benoit，1995年；Benoit，Zeanah，Parker，Nicholson，& Coolbear，1997年）。研究发现围产期风险的严重程度会对母亲的依恋表征产生影响。在6个月时，早产婴儿的母亲中只有20%（18个月时为30%）有安全型依恋表征，而对照组为53%（18个月时为57%）。此外，低风险早产婴儿的母亲更常出现疏离型表征，而高风险早产婴儿组中扭曲型表征更为常见。这些发现表明，父母对早产的反应与产后风险的严重程度有关。低风险婴儿母亲和高风险婴儿母亲的安全型依恋表征都受到影响这一事实，表明有必要进一步开展研究，以评估对低风险和高风险早产情况进行预防性干预是否会有帮助。
