Provenzi Livio, Fumagalli Monica, Bernasconi Federica, Sirgiovanni Ida, Morandi Francesco, Borgatti Renato, Montirosso Rosario
0-3 Centre for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea.
NICU, Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ca' Granda.
Infancy. 2017 Sep;22(5):695-712. doi: 10.1111/infa.12175. Epub 2016 Dec 19.
Very preterm (VPT) infants are at risk for altered socio-emotional stress regulation, even in the absence of perinatal complications. Moreover, becoming a mother of a VPT infant is a traumatic event, which might affect the establishment of a bonding relationship toward the infant during the postnatal period. The main aim of the present study was to assess the association between maternal postnatal bonding and socio-emotional stress response in 3-month-old VPT infants, compared to full-term (FT) controls. Thirty-three VPT and 28 FT infant-mother dyads underwent the maternal Face-to-Face Still-Face (FFSF) procedure to assess socio-emotional stress regulation. Maternal postnatal bonding was measured through the Maternal Post-Natal Attachment Scale (MPAS), which includes three scales: Quality of attachment, Absence of hostility, and Pleasure in interaction. The VPT infants exhibited less self-directed and other-directed regulatory behaviors during the Still-Face episode. Mothers of VPT infants reported lower Quality of attachment compared to FT counterparts. Importantly, higher levels of Quality of attachment were associated with more other-directed behaviors during the Still-Face episode in FT dyads, whereas this was not observed in VPT dyads. In conclusion, VPT infants might be exposed to a double-risk condition for socio-emotional development, encompassing both difficulties in stress response and the exposure to a less-than-optimal maternal bonding.
极早产儿（VPT）即使在没有围产期并发症的情况下，也存在社会情感应激调节改变的风险。此外，成为一名极早产儿的母亲是一个创伤性事件，这可能会影响产后与婴儿建立亲密关系。本研究的主要目的是评估与足月儿（FT）对照组相比，极早产儿在3个月大时母亲产后亲密关系与社会情感应激反应之间的关联。33对极早产儿和28对足月儿母婴进行了母亲面对面静止脸（FFSF）程序，以评估社会情感应激调节。通过母亲产后依恋量表（MPAS）测量母亲产后的亲密关系，该量表包括三个分量表：依恋质量、无敌意和互动愉悦感。在静止脸环节，极早产儿表现出较少的自我导向和他人导向的调节行为。与足月儿的母亲相比，极早产儿的母亲报告的依恋质量较低。重要的是，在足月儿母婴对中，较高的依恋质量水平与静止脸环节中更多的他人导向行为相关，而在极早产儿母婴对中未观察到这种情况。总之，极早产儿在社会情感发展方面可能面临双重风险，包括应激反应困难以及接触到不太理想的母亲亲密关系。
