Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
J Affect Disord. 2024 Mar 15;349:370-376. doi: 10.1016/j.jad.2024.01.001. Epub 2024 Jan 8.
The quality of mother-to-infant bonding (MIB) is a crucial determinant of nurturing behaviors and infant development, with bonding difficulties (MIBD) posing a substantial threat. While it is essential to identify MIBD risk factors, previous studies have generally examined MIBD at one time point, leaving the contributors to persistent MIBD uncertain. This study aims to discern longitudinal risk factors for persistent versus episodic MIBD.
We evaluated 1833 postpartum Japanese women who delivered in the past twelve months, utilizing the Mother-to-Infant Bonding Scale (MIBS) and other sociodemographic, health, pregnancy, childbirth, and child-rearing related data (T1). Follow-up data were obtained six months later (T2). MIBD was defined as a MIBS score of five or more, with "persistent" and "episodic" MIBD classified based on its occurrence at both or either one of the time points, respectively. Logistic generalized estimating equations and inverse probability weighting were used to identify risk factors and address selective attribution bias.
Of the subjects, 15.8 % reported episodic and 11.3 % reported persistent MIBD. Shared risk factors for both conditions included postpartum depression and low levels of family support (OR = 1.501-6.343). However, pre-pregnancy underweight status (OR = 1.698) was a unique risk factor for episodic MIBD, while first-time motherhood, no or discontinuation of breastfeeding, and later postpartum months (OR = 1.540-3.179) were distinctive risk factors for persistent MIBD.
We identified both shared and unique risk factors for episodic and persistent MIBD. Particular attention should be afforded to persistent MIBD and early and proactive interventions to mitigate identified risk factors are recommended.
母婴联结质量（MIB）是养育行为和婴儿发育的关键决定因素，而母婴联结困难（MIBD）构成了重大威胁。虽然识别 MIBD 的风险因素至关重要，但先前的研究通常只在一个时间点检查 MIBD，因此不确定导致持续 MIBD 的因素。本研究旨在辨别持续和偶发性 MIBD 的纵向风险因素。
我们评估了过去 12 个月内在日本分娩的 1833 名产后女性，使用母婴联结量表（MIBS）和其他社会人口学、健康、妊娠、分娩和育儿相关数据（T1）。六个月后（T2）获得随访数据。MIBD 的定义是 MIBS 评分达到 5 分或以上，根据其在两个时间点中的一个或两个时间点发生的情况，将“持续”和“偶发性”MIBD 进行分类。使用逻辑广义估计方程和逆概率加权来识别风险因素并解决选择性归因偏差。
在研究对象中，15.8%报告偶发性 MIBD，11.3%报告持续性 MIBD。两种情况的共同风险因素包括产后抑郁和家庭支持水平低（OR=1.501-6.343）。然而，孕前体重不足（OR=1.698）是偶发性 MIBD 的独特风险因素，而初产妇、不哺乳或中断哺乳以及产后较晚的月份（OR=1.540-3.179）是持续性 MIBD 的独特风险因素。
我们确定了偶发性和持续性 MIBD 的共同和独特风险因素。特别关注持续性 MIBD，并建议早期积极干预以减轻已识别的风险因素。
