Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
Out of Hospital Pediatrician, Vienna, Austria.
Acta Paediatr. 2023 Aug;112(8):1725-1733. doi: 10.1111/apa.16843. Epub 2023 May 30.
Successful mother-child-bonding is a fundamental step for a healthy development of the child. Different factors like postpartum depression can hinder the bonding process. This study aimed to investigate how intensive care treatment due to congenital heart diseases of the infant alters bonding and how mothers cope with the situation.
Validated questionnaires were used to analyse postpartum depression, mother-child bonding, stress factors and coping strategies for mothers at a paediatric intensive care unit (PICU; n = 38) and a group of mothers without known psychiatric disorders attending a babywell visit with their child (n = 91). Descriptive statistics and interaction models were calculated.
The PICU group showed on average higher total scores on the postpartum bonding questionnaire indicating mother-child bonding impairment and a higher proportion of mothers with depression was observed (76% vs 11%). The model showed a significant interaction between effective coping strategies and mother infant bonding (p = 0.04). Ineffective coping had no effect on bonding or depression in the PICU group.
Mothers of children treated at an ICU due a congenital heart disease are at increased risk for the development of depression and difficulties in different aspects of postpartum bonding. Our results show that coping mechanisms might significantly influence postpartum bonding. Implementation of tailored support is needed to optimise maternal outcomes.
成功的母婴结合是儿童健康发展的基本步骤。产后抑郁症等不同因素可能会阻碍结合过程。本研究旨在调查婴儿因先天性心脏病而接受重症监护治疗如何改变母婴结合,并了解母亲如何应对这种情况。
使用经过验证的问卷分析儿科重症监护病房(PICU;n=38)和一组无已知精神疾病的母亲在婴儿健康检查时(n=91)的产后抑郁症、母婴结合、压力因素和应对策略。计算了描述性统计数据和交互模型。
PICU 组的产后结合问卷总分平均较高,表明母婴结合受损,且观察到更多的母亲患有抑郁症(76% vs 11%)。该模型显示有效应对策略和母婴结合之间存在显著的交互作用(p=0.04)。在 PICU 组中,无效应对策略对结合或抑郁没有影响。
因先天性心脏病而在 ICU 接受治疗的儿童的母亲患抑郁症和产后母婴结合不同方面出现困难的风险增加。我们的结果表明,应对机制可能会对母婴结合产生重大影响。需要实施有针对性的支持,以优化产妇结局。