Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
Division of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Arch Womens Ment Health. 2021 Jun;24(3):483-492. doi: 10.1007/s00737-020-01098-w. Epub 2020 Dec 17.
Fear of childbirth (FOC) is a common phenomenon that can impair functioning in pregnancy but potential longer term implications for the mother-infant relationship are little understood. This study was aimed at investigating postpartum implications of FOC on the mother-infant relationship. A UK sample of 341 women in a community setting provided data on anxiety, mood and FOC in mid-pregnancy and subsequently completed self-report measures of postnatal bonding in a longitudinal cohort study. Postnatal observations of mother-infant interactions were collected and rated for a subset of 141 women. FOC was associated with maternal perception of impaired bonding, even after controlling for sociodemographic factors, concurrent depression and the presence of anxiety disorders (Coef = 0.10, 95% CI 0.07-0.14, p < 0.001). Observed mother-infant interactions were not associated with FOC (Coef = -0.01-0.03 CI - 0.02 to 0.02, p = 0.46), weakly with concurrent depression (Coef = - 0.10, CI - 0.19 to 0.00, p = 0.06) and not associated with anxiety disorders. The self-efficacy component of FOC was most strongly associated with lower reported bonding (Coef 0.37, 95% CI 0.25-0.49, p < 0.001) FOC makes a distinct contribution to perceived postpartum bonding difficulties but observed mother-infant interaction quality was not affected. This may be due to low self-efficacy impacting psychological adjustment during pregnancy. Targeted interventions during pregnancy focusing both on treatment of key childbirth fears and bonding could help women adjust earlier.
对分娩的恐惧（FOC）是一种常见现象，它会影响孕妇的身体机能，但对母婴关系的潜在长期影响却知之甚少。本研究旨在调查 FOC 对母婴关系的产后影响。在一项以社区为基础的英国样本中，341 名孕妇在妊娠中期提供了焦虑、情绪和 FOC 数据，随后在一项纵向队列研究中完成了产后母婴联系的自我报告测量。对 141 名女性中的一部分进行了母婴互动的产后观察和评分。即使在控制了社会人口因素、并发抑郁和焦虑障碍的存在后，FOC 仍与母亲对不良联系的感知有关（系数=0.10，95%CI 0.07-0.14，p<0.001）。观察到的母婴互动与 FOC 无关（系数=−0.01-0.03，CI -0.02 到 0.02，p=0.46），与并发抑郁呈弱相关（系数=−0.10，CI -0.19 到 0.00，p=0.06），与焦虑障碍无关。FOC 的自我效能感成分与报告的较低联系程度最相关（系数 0.37，95%CI 0.25-0.49，p<0.001）。FOC 对产后联系困难有明显的影响，但观察到的母婴互动质量没有受到影响。这可能是由于低自我效能感影响了孕妇在怀孕期间的心理调整。在怀孕期间，针对关键分娩恐惧和联系的针对性干预可能有助于女性更早地进行调整。
