Abstract
The emotional bond that a mother feels towards her baby is critical to social, emotional and cognitive development. Maternal health and wellbeing through pregnancy and antenatal bonding also play a key role in determining bonding postnatally, but the extent to which these relationships may be disrupted by poor mental health or substance use is unclear. This study aimed to examine the extent to which mother-fetal bonding, substance use and mental health through pregnancy predicted postnatal mother-infant bonding at 8 weeks. Participants were 372 women recruited from three metropolitan hospitals in Australia. Data was collected during trimesters one, two and three of pregnancy and 8 weeks postnatal using the Maternal Antenatal Attachment Scale (MAAS), Maternal Postnatal Attachment Scale (MPAS), the Edinburgh Antenatal and Postnatal Depression Scale (EPDS), the Depression and Anxiety Scales (DASS-21), frequency and quantity of substance use (caffeine, alcohol and tobacco) as well as a range of demographic and postnatal information. Higher antenatal bonding predicted higher postnatal bonding at all pregnancy time-points in a fully adjusted regression model. Maternal depressive symptoms in trimesters two and three and stress in trimester two were inversely related to poorer mother-infant bonding 8 weeks postnatally. This study extends previous work on the mother’s felt bond to her developing child by drawing on a large sample of women and documenting the pattern of this bond at three time points in pregnancy and at 8 weeks postnatally. Utilising multiple antenatal waves allowed precision in isolating the relationships in pregnancy and at key intervention points. Investigating methods to enhance bonding and intervene in pregnancy is needed. It is also important to assess maternal mental health through pregnancy.
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References
Ainsworth MDS, Blehar MC, Waters E, Wall S (1978) Patterns of attachment. A psychological study of the strange situation. Erlbaum, Hillsdale, NJ
Alhusen JL, Gross D, Hayat MJ, Rose L, Sharps P (2012) The role of mental health on maternal-fetal attachment in low-income women. J Obstet Gynecol Neonatal Nurs 41(6):E71–E81
Armstrong D, Hutti M (1998) Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachment. J Obstet Gynecol Neonatal Nurs 27(2):183–189
Austin M-P, Hadzi-Pavlovic D, Leader L, Saint K, Parker G (2005) Maternal trait anxiety, depression and life event stress in pregnancy: relationships with infant temperament. Early Hum Dev 81(2):183–190
Belsky J, Rovine M, Taylor DG (1984) The Pennsylvania infant and family development project, III: the origins of individual differences in infant-mother attachment: maternal and infant contributions. Child Dev 55(3):718–728
Brandon AR, Pitts S, Denton WH, Stringer CA, Evans HM (2009) A history of the theory of prenatal attachment. J Prenat Perinatal Psychol Health 23(4):201–222
Brockington IF (1996) Motherhood and mental health. Oxford University Press, Oxford
Brockington IF (2004) Postpartum psychiatric disorders. Lancet 363(9405):303–310
Brockington I, Oates J, George S, Turner D, Vostanis P, Sullivan M, Loh C, Murdoch C (2001) A screening questionnaire for mother-infant bonding disorders. Arch Womens Ment Health 3(4):133–140
Choi H, Yamashita T, Wada Y, Narumoto J, Nanri H, Fujimori A, Yamamoto H, Nishizawa S, Masaki D, Fukui K (2010) Factors associated with postpartum depression and abusive behavior in mothers with infants. Psychiatry Clin Neurosci 64(2):120–127
Condon JT (1993) The assessment of antenatal emotional attachment: development of a questionnaire instrument. Br J Med Psychol 66:167–183
Condon JT, Corkindale CJ (1998) The assessment of parent-to-infant attachment: development of a self-report questionnaire instrument. J Reprod Infant Psychol 16(1):57–76
Condon JT, Dunn DJ (1988) Nature and determinants of parent-to-infant attachment in the early postnatal period. J Am Acad Child Adolesc Psychiatry 27(3):293–299
Cranley MS (1981) Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res 30(5):281–284
Curry MA (1987) Maternal behavior of hospitalized pregnant women. J Psychosom Obstet Gynecol 7(3):165–182
Damato EG (2004) Prenatal attachment and other correlates of postnatal maternal attachment to twins. Adv Neonatal Care 4(5):274–291
De Cock ESA, Maas AJBM, Vreeswijk CMJM, Van Bakel HJA (2011) Maternal prenatal attachment and mother-infant interaction at 6 months of age. Paper presented at the 15th European Conference on Developmental Psychology, 40128 Bologna.
Diniz E, Koller SH, Volling BL (2015) Social support and maternal depression from pregnancy to postpartum: the association with positive maternal behaviours among Brazilian adolescent mothers. Early Child Dev Care 185(7):1053–1066. doi:10.1080/03004430.2014.978309
Feldman R, Gordon I, Zagoory-Sharon O (2011) Maternal and paternal plasma, salivary, and urinary oxytocin and parent–infant synchrony: considering stress and affiliation components of human bonding. Dev Sci 14(4):752–761
Finke MD, Rojo S, Roos N, van Huis A, Yen AL (2015) The European Food Safety Authority scientific opinion on a risk profile related to production and consumption of insects as food and feed. J Insects Food Feed 1(4):245–247
Gaffney KF (1986) Maternal–fetal attachment in relation to self-concept and anxiety. Matern Child Nurs J 15(2):91–101
Goecke TW, Voigt F, Faschingbauer F, Spangler G, Beckmann MW, Beetz A (2012) The association of prenatal attachment and perinatal factors with pre- and postpartum depression in first-time mothers. Arch Gynecol Obstet 286(2):309–316
Grace JT (1989) Development of maternal-fetal attachment during pregnancy. Nurs Res 38(4):228–232
Grant KA, McMahon C, Austin MP (2008) Maternal anxiety during the transition to parenthood: a prospective study. J Affect Disord 108(1–2):101–111
Grant K-A, McMahon C, Reilly N, Austin M-P (2010) Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant mental development. Early Hum Dev 86(9):551–556
Green J, Goldwyn R (2002) Annotation: Attachment disorganisation and psychopathology: new findings in attachment research and their potential implications for developmental psychopathology in childhood. J Child Psychol Psychiatry 43(7):835–846
Hamilton CE (2000) Continuity and discontinuity of attachment from infancy through adolescence. Child Dev 71(3):690–694
Hart R, McMahon CA (2006) Mood state and psychological adjustment to pregnancy. Arch Womens Ment Health 9(6):329–337
Hawthorne G, Elliott P (2005) Imputing cross-sectional missing data: comparison of common techniques. Aust N Z J Psychiatry 39(7):583–590
Hilder L, Zhichao Z, Parker M, Jahan S, Chambers GM (2014) Australia’s mothers and babies 2012. Perinatal statistics series no. 30. In: Australian Institute of Health and Welfare (ed), (cat. no. PER 69 ed.). AIHW National Perinatal Epidemiology and Statistics Unit, Canberra
Huisman M (2000) Imputation of missing item responses: some simple techniques. Qual Quant 34(4):331–351
Hutchinson D, Moore EA, Breen C, Burns L, Mattick RP (2013) Alcohol use in pregnancy: prevalence and predictors in the longitudinal study of Australian children. Drug Alcohol Rev 32(5):475–482
Lindgren K (2001) Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Res Nurs Health 24(3):203–217
Lindgren K (2003) A comparison of pregnancy health practices of women in inner-city and small urban communities. J Obstet Gynecol Neonatal Nurs 32(3):313–321
LovibondP (1995) Manual for the Depression Anxiety Stress Scales short-form (DASS-21). Sydney: Sydney Psychology edition
McFarland J, Salisbury A, Battle C, Hawes K, Halloran K, Lester B (2011) Major depressive disorder during pregnancy and emotional attachment to the fetus. Arch Womens Ment Health 14(5):425–434
McMahon C, Ungerer JA, Tennant C, Saunders D (1997) Psychosocial adjustment and the quality of the mother-child relationship at four months postpartum after conception by in vitro fertilization. Fertil Steril 68(3):493–500
Mercer RT, Ferketich SL (1990) Predictors of parental attachment during early parenthood. J Adv Nurs 15(3):268–280
Müller ME (1996) Prenatal and postnatal attachment: a modest correlation. J Obstet Gynecol Neonatal Nurs 25(2):161–166
O’Connor MJ, Paley B (2006) The relationship of prenatal alcohol exposure and the postnatal environment to child depressive symptoms. J Pediatr Psychol 31(1):50–64
O’Connor MJ, Sigman M, Kasari C (1992) Attachment behavior of infants exposed prenatally to alcohol: mediating effects of infant affect and mother-infant interaction. Dev Psychopathol 4(02):243–256
O’Connor MJ, Sigman M, Kasari C (1993) Interactional model for the association among maternal alcohol use, mother-infant interaction, and infant cognitive development. Infant Behav Dev 16(2):177–192
O’Connor MJ, Kogan N, Findlay R (2002a) Prenatal alcohol exposure and attachment behavior in children. Alcohol Clin Exp Res 26(10):1592–1602
O’Connor MJ, Kogan N, Findlay R (2002b) Prenatal alcohol exposure and attachment behavior in children. Alcohol Clin Exp Res 26(10):1592–1602
O’Connor TG, Heron J, Golding J, Beveridge M, Glover V (2002c) Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 180(6):502–508
Ohoka H, Koide T, Goto S, Murase S, Kanai A, Masuda T, Aleksic B, Ishikawa N, Furumura K, Ozaki N (2014) Effects of maternal depressive symptomatology during pregnancy and the postpartum period on infant-mother attachment. Psychiatry Clin Neurosci 68(8):631–639
O’Leary CM, Bower C, Zubrick SR, Geelhoed E, Kurinczuk JJ, Nassar N (2010) A new method of prenatal alcohol classification accounting for dose, pattern and timing of exposure: improving our ability to examine fetal effects from low to moderate alcohol. J Epidemiol Community Health 64:956–962
Ossa X, Bustos L, Fernandez L (2012) Prenatal attachment and associated factors during the third trimester of pregnancy in Temuco, Chile. Midwifery 28(5):e689–e696
Patock-Peckham JA, Morgan-Lopez AA (2010) Direct and mediational links between parental bonds and neglect, antisocial personality, reasons for drinking, alcohol use, and alcohol problems. J Stud Alcohol Drugs 71(1):95
Quinlivan JA, Evans SF (2005) Impact of domestic violence and drug abuse in pregnancy on maternal attachment and infant temperament in teenage mothers in the setting of best clinical practice. Arch Womens Ment Health 8(3):191–199
Righetti-Veltema M, Conne-Perreard E, Bousquet A, Manzano J (2002) Postpartum depression and mother-infant relationship at 3 months old. J Affect Disord 70(3):291–306
Schore AN (2001) The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Ment Health J 22(1–2):201–269
Sedgmen B, McMahon C, Cairns D, Benzie RJ, Woodfield RL (2006) The impact of two-dimensional versus three-dimensional ultrasound exposure on maternal–fetal attachment and maternal health behavior in pregnancy. Ultrasound Obstet Gynecol 27(3):245–251
Siddiqui A, Hagglof B (2000) Does maternal prenatal attachment predict postnatal mother-infant interaction? Early Hum Dev 59(1):13–25
Stanton F, Golombok S (1993) Maternal-fetal attachment during pregnancy following in vitro fertilization. J Psychosom Obstet Gynecol 14(2):153–158
Thun-Hohenstein L, Wienerroither C, Schreuer M, Seim G, Wienerroither H (2008) Antenatal mental representations about the child and mother–infant interaction at three months post partum. Eur Child Adolesc Psychiatry 17(1):9–19
Van Bussel JCH, Spitz B, Demyttenaere K (2010a) Reliability and validity of the Dutch version of the maternal antenatal attachment scale. Arch Womens Ment Health 13(3):267–277
Van Bussel JCH, Spitz B, Demyttenaere K (2010b) Three self-report questionnaires of the early mother-to-infant bond: reliability and validity of the Dutch version of the MPAS, PBQ and MIBS. Arch Womens Ment Health 13(5):373–384
Van den Bergh BRH, Mulder EJH, Mennes M, Glover V (2005) Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev 29(2):237–258
Warren SL, Huston L, Egeland B, Sroufe LA (1997) Child and adolescent anxiety disorders and early attachment. J Am Acad Child Adolesc Psychiatry 36(5):637–644
Waters E, Weinfield NS, Hamilton CE (2000) The stability of attachment security from infancy to adolescence and early adulthood: general discussion. Child Dev 71(3):703–706
Acknowledgements
The research was funded by an Australian National Health and Medical Research Council (NHMRC) Project Grant #GNT630517 for $2,196,179 to Richard P Mattick, Delyse Hutchinson, Steve Allsop, Jake Najman, Elizabeth Elliott, Lucy Burns, Sue Jacobs, Craig A Olsson and Anne Bartu, and was financially supported by the National Drug and Alcohol Research Centre (NDARC), University of NewSouth Wales (UNSW), and the National Drug Research Institute (NDRI), Curtin University. NDARC and NDRI are funded by the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund. Richard P Mattick is financially supported by an NHMRC Principal Research Fellowship Award from the NHMRC; Delyse Hutchinson is financially supported by an Australian Unity Industry Partner Senior Research Fellowship; Craig Olsson is supported by an Australian Research Council Senior Research Fellowship (DORA: DP 130101459); and, Elizabeth Elliott is supported by an NHMRC Practitioner Fellowship (#1021480).
We gratefully acknowledge the investigators not listed as authors; the research staff and students who assisted with collection of the data; the hospitals and antenatal clinics for their assistance with recruitment; and, the study participants and their families. We also wish to acknowledge the Longitudinal Cohorts Research Consortium (LCRC; Formerly the Cannabis Cohorts Research Consortium; NHMRC Project Grants: AAP1009381, AAP1064893).
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Rossen, L., Hutchinson, D., Wilson, J. et al. Predictors of postnatal mother-infant bonding: the role of antenatal bonding, maternal substance use and mental health. Arch Womens Ment Health 19, 609–622 (2016). https://doi.org/10.1007/s00737-016-0602-z
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DOI: https://doi.org/10.1007/s00737-016-0602-z