Hall Ruby A S, Hoffenkamp Hannah N, Braeken Johan, Tooten Anneke, Vingerhoets Ad J J M, van Bakel Hedwig J A
Department of Tranzo, Scientific Center for Care and Welfare, Tilburg University, The Netherlands.
International Victimology Institute Tilburg, Tilburg University, The Netherlands.
Infant Behav Dev. 2017 Nov;49:272-280. doi: 10.1016/j.infbeh.2017.09.012. Epub 2017 Nov 2.
Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly prevalent in mothers of preterm born infants, necessarily affect a mother's quality of parenting.
Latent Class Analysis was used to group mothers (N=197) of term, moderately, and very preterm born infants, based on their levels of distress (depression, anxiety, and PTSD symptoms) at one month postpartum, and their quality of parenting at one and six months postpartum. Parenting quality was assessed on the basis of maternal interactive behaviors (sensitivity, intrusiveness, and withdrawal) using observations, and maternal attachment representations (balanced, disengaged, or distorted) using interviews.
A 5-Class model yielded the best fit to the data. The first Class (47%) of mothers was characterized by low distress levels and high-quality parenting, the second Class (20%) by low distress levels and low-quality parenting, the third Class (22%) by high distress levels and medium-quality parenting, the fourth Class (9%) by high distress levels and high-quality parenting, and finally the fifth Class (2%) by extremely high levels of distress and low-quality parenting.
While heightened distress levels seem inherent to preterm birth, there appears to be substantial heterogeneity in mothers' emotional responsivity. This study indicates that relatively high levels of distress after preterm birth do not necessarily place these mothers at increased risk with regard to poor parenting. Conversely, low distress levels do not necessarily indicate good-quality parenting. The results of the present study prompt a reconsideration of the association between postpartum distress and parenting quality, and challenge the notion that high levels of maternal distress always result in low-quality parenting practices.
产后母亲的困扰通常被视为育儿能力差的一个标志。然而，关于产后困扰对养育早产儿的影响，我们所知甚少。本研究调查了早产婴儿母亲中特别普遍的高度困扰水平是否必然会影响母亲的养育质量。
潜在类别分析用于根据产后1个月时的困扰水平（抑郁、焦虑和创伤后应激障碍症状）以及产后1个月和6个月时的养育质量，将足月儿、中度早产儿和极早产儿的母亲（N = 197）进行分组。养育质量通过观察母亲的互动行为（敏感性、侵扰性和退缩）以及通过访谈母亲的依恋表征（平衡、疏离或扭曲）来评估。
一个5类别模型对数据拟合最佳。第一类母亲（47%）的特点是困扰水平低且养育质量高，第二类（20%）是困扰水平低且养育质量低，第三类（22%）是困扰水平高且养育质量中等，第四类（9%）是困扰水平高且养育质量高，最后第五类（2%）是困扰水平极高且养育质量低。
虽然早产似乎必然伴随着更高的困扰水平，但母亲的情绪反应存在很大的异质性。本研究表明，早产产后相对较高的困扰水平并不一定会使这些母亲面临养育能力差的风险增加。相反，低困扰水平也不一定表明养育质量好。本研究结果促使人们重新考虑产后困扰与养育质量之间的关联，并挑战了母亲高度困扰总是导致养育质量差的观念。
