Department of Gynecology and Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Matern Fetal Neonatal Med. 2020 Aug;33(16):2789-2796. doi: 10.1080/14767058.2018.1560414. Epub 2019 Apr 15.
To survey the frequency and risk factors for father-to-infant lack of affection (LA) and anger/rejection (AR) bonding failure at 1 month postpartum. The study participants enrolled in the prospective birth cohort study of an adjunct study of the Japan Environment & Children's Study. Bonding failure, psychological distress during pregnancy and postnatal depression symptoms were evaluated using the Japanese version of the Mother-Infant Bonding Scale (MIBS-J), the Kessler 6-item (K6) psychological distress scale and the Edinburgh Postnatal Depression Scale (EPDS-J). This study extracted relative factors based on approximately 10% occupancy of the total high scores in MIBS-J subscales as a cut-off for bonding failure. The cut-off scores on the paternal EPDS-J were eight, on maternal EPDS-J was 9, and on the K6 psychological distress scale score was 13. A total of 1008 couples who had single delivery were assessed at 1 month postpartum, respectively. The prevalence of paternal MIBS-J_LA scores ≥4 was 8.3%, MIBS-J_AR scores ≥3 was 7.9%, and EPDS-J scores ≥8 was 11.2%, respectively. In the multiple logistics analysis, paternal MIBS-J_LA scores ≥4 were significantly associated with maternal MIBS-J_LA score ≥3 (adjusted odds ratio (AOR) 2.814; 95% confidence interval (CI): 1.377-5.747), mental intimate partner violence (IPV) against the mother during pregnancy (AOR 2.176; 95% CI: 1.185-3.997), maternal K6 psychological distress scale score ≥13 (AOR 2.980; 95% CI: 1.317-6.745), paternal EPDS-J score ≥8 (AOR 3.227; 95% CI: 1.767-5.892), and a history of mental health disorder (AOR 4.125; 95% CI: 1.423-11.963). Paternal MIBS-J_AR scores ≥3 were significantly associated with maternal MIBS-J_AR scores ≥3 (AOR 5.082; 95% CI: 2.453-10.529), a history of physical IPV against the mother during pregnancy (AOR 5.230; 95% CI: 1.016-26.920), paternal K6 psychological distress scale score ≥13 (AOR 4.145; 95% CI: 1.311-13.107), and paternal EPDS-J scores ≥8 (AOR 4.479; 95% CI: 2.503-8.013). In Pearson's product moment correlation coefficient analyses between paternal and maternal MIBS-J score, MIBS-J_LA score was = 0.2112, < .0001, and MIBS-J_AR score was = 0.3281, < .0001. Father-to-infant lack of affection bonding failure was associated with mother-to-infant lack of affection bonding failure, mental IPV against mother during pregnancy, maternal psychological distress during pregnancy, paternal postpartum depression symptoms, and history of paternal mental health disorders. Father-to-infant anger/rejection bonding failure was associated with mother-to-infant anger/rejection bonding failure, physical IPV against mother during pregnancy, paternal psychological distress during pregnancy, and paternal postpartum depression symptoms. Since bonding failure is a risk factor for infant maltreatment, further investigations are recommended to fully assess these associations to resolve parent perinatal mental health issues for preventing father-to-infant bonding failure.
调查产后 1 个月时父亲与婴儿缺乏亲情(LA)和愤怒/拒绝(AR)关系不良的频率和风险因素。研究参与者纳入了日本环境与儿童研究的辅助研究的前瞻性出生队列研究。使用母亲-婴儿 bonding 量表(MIBS-J)的日语版、Kessler 6 项(K6)心理困扰量表和爱丁堡产后抑郁量表(EPDS-J)评估 bonding 失败、妊娠期间的心理困扰和产后抑郁症状。本研究根据 MIBS-J 子量表的总分约 10%的占有率提取相对因素作为 bonding 失败的截止值。父亲 EPDS-J 的截止分数为 8,母亲 EPDS-J 的截止分数为 9,K6 心理困扰量表分数为 13。共有 1008 对单胎分娩的夫妇在产后 1 个月时进行了评估。父亲 MIBS-J_LA 评分≥4 的发生率为 8.3%,MIBS-J_AR 评分≥3 的发生率为 7.9%,EPDS-J 评分≥8 的发生率为 11.2%。在多因素逻辑回归分析中,父亲 MIBS-J_LA 评分≥4 与母亲 MIBS-J_LA 评分≥3(调整后的优势比(AOR)2.814;95%置信区间(CI):1.377-5.747)、妊娠期间针对母亲的精神亲密伴侣暴力(IPV)(AOR 2.176;95%CI:1.185-3.997)、母亲 K6 心理困扰量表评分≥13(AOR 2.980;95%CI:1.317-6.745)、父亲 EPDS-J 评分≥8(AOR 3.227;95%CI:1.767-5.892)和精神健康障碍史(AOR 4.125;95%CI:1.423-11.963)显著相关。父亲 MIBS-J_AR 评分≥3 与母亲 MIBS-J_AR 评分≥3(AOR 5.082;95%CI:2.453-10.529)、妊娠期间针对母亲的身体 IPV 史(AOR 5.230;95%CI:1.016-26.920)、父亲 K6 心理困扰量表评分≥13(AOR 4.145;95%CI:1.311-13.107)和父亲 EPDS-J 评分≥8(AOR 4.479;95%CI:2.503-8.013)显著相关。在父亲和母亲 MIBS-J 评分之间的 Pearson 积矩相关系数分析中,MIBS-J_LA 评分 = 0.2112, < .0001,MIBS-J_AR 评分 = 0.3281, < .0001。父亲与婴儿缺乏亲情关系不良与母亲与婴儿缺乏亲情关系不良、妊娠期间针对母亲的精神 IPV、母亲妊娠期间的心理困扰、父亲产后抑郁症状和父亲精神健康障碍史有关。父亲与婴儿的愤怒/拒绝关系不良与母亲与婴儿的愤怒/拒绝关系不良、妊娠期间针对母亲的身体 IPV、父亲妊娠期间的心理困扰和父亲产后抑郁症状有关。由于 bonding 失败是婴儿虐待的一个危险因素,因此建议进一步调查这些关联,以充分评估这些关联,解决父母围产期的心理健康问题,防止父亲与婴儿的 bonding 失败。