Promoting Mother-to-Baby Attachment to Prevent Postpartum Depression: An Intervention Study
DOI:
https://doi.org/10.17140/WHOJ-4-128Keywords:
Attachment; Bonding; Child abuse; Postpartum; Antepartum; Depression; AnxietyAbstract
Aim
Weak attachment to the fetus during pregnancy has been linked to postpartum depression and child abuse. A longitudinal study was
conducted to verify the hypothesis that postpartum depression decreases when bonding between the mothers to fetus is promoted
during pregnancy. This study aimed to verify the hypothesis that postpartum depression decreases when bonding is promoted
during pregnancy.
Methods
One hundred and fifty-seven pregnant women were enrolled in a mothers’ class and were divided into either a control or intervention group. The intervention group listened to music and maintained a “fetal diary”. The control group received no additional
instructions beyond the mothers’ class. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen pregnancy and
postpartum depression. The Mother-to-Infant Bonding Scale (MIBS) and the Prenatal Attachment Inventory/Maternal Attachment Inventory were used to evaluate mothers’ attachment to the fetus/neonate. The paired t-test and Fisher’s exact test were
used to compare scores within and between the two groups in the antepartum and postpartum periods. The level of statistical
significance was set to p<0.05.
Results
Data were obtained for 85 (54.1%) women (control group: n=47, intervention group: n=38). Approximately 19% and 20.4% of
participants were in a depressive state in the antepartum and postpartum periods, respectively. There was no difference in depressive state between the antepartum and postpartum periods in the intervention group. However, EPDS scores were increased in
the period of postpartum than antepartum in the control group (p=0.05). There were no significant differences in MIBS scores
between the control and intervention groups in the antepartum period. However, MIBS scores were significantly higher in the control group in the postpartum period (p=0.001). The intervention group showed a reduction in mothers’ negative feelings towards
the baby between the antepartum and postpartum periods than the control group.
Conclusion
The results supported the hypothesis that postpartum depression decreased when bonding between the mothers to fetus is promoted during pregnancy
References
Ministry of Health, Labor and Welfare. The Verification Results of the Death Caused by Child Abuse Cases Web site: http://www. mhlw.go.jp/file/06-Seisakujouhou-11900000-Koyoukintoujidou-kateikyoku/0000177954.pdf. Accessed May 17, 2018.
Ministry of Health, Labor and Welfare. Sukoyaka Oyako 21. Web site: http://sukoyaka21.jp/. Accessed May 22, 2018.
Brockington I. Postpartum psychiatric disorders. The Lancet. 2004; 363: 303-310. doi: 10.1016/S0140-6736(03)15390-1
Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014; 28: 25-35. doi: 10.1016/j.bpob-gyn.2013.08.017
Cooper PJ, Pascalis LD, Woolgar M, Romaniuk H, Murray L. At-tempting to prevent postnatal depression by targeting the mother-infant relationship: A randomized controlled trial. Prim Health Care Res Dev. 2015; 16: 383-397. doi: 10.1017/S1463423614000401
Jacqueline MC, Elenor SB, Karin CR, et al. The development and validation of the prospective factors survey: A self-report measure of protective factors against child maltreatment. Child Abuse & Ne-glect. 2010; 34(10): 762-772. doi: 10.1016/j.chiabu.2010.03.003
Sugishita K., Kamibeppu K, Matsuo H. The inter relationship of mental state between antepartum and postpartum assessed by depression and bonding scales in mothers. Health. 2016; 8: 1234- 1243. doi: 10.4236/health.2016.812126
Cox J. Use and misuse of the Edinburgh Postnatal Depression Scale (EPDS): A ten point ‘survival analysis’. Arch Womens Ment Health. 2017; 20(6): 789-790. doi: 10.1007/s00737-017-0789-7
Okano T. Validation and reliability of Japanese version of the EPDS. Archives of Psychiatric Diagnostics and Clinical Evaluation. 1996; 7: 525-533.
Kumar RC. Anybody’s child” severe disorders of mother-to-infant bonding. Br J Psychiatry. 1997; 171: 175-181. doi: 10.1192/ bjp.171.2.175
Yamashita H, Yoshida K. Investigation of community-based preventive intervention using questionnaires for mothers at risk for child abuse: contribution of perinatal psychiatry to child abuse in infancy. Japanese Journal of Child Abuse and Neglect. 2004; 6: 218-231.
Yoshida K., Yamashita H, Conroy S, Marks M, Kumar C. A Japanese version of mother-infant bonding scale: Factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers. Arch Womens Ment Health. 2012; 15: 343-352. doi: 10.1007/s00737-012-0291-1
Muller ME. Development of the prenatal attach-ment inventory. West J Nurs Res. 1993; 15: 199-215. doi: 10.1177/019394599301500205
Muller ME. A questionnaire to measure mother-to-infant attachment. J Nurs Meas. 1994; 2: 129-141. doi: 10.1891/1061- 3749.2.2.129
Sugishita K, Kamibeppu K. Relationship between prepartum Submit your article to this journal | https://openventio.org/submit-manuscript/ and postpartum depression to use EPDS. Japanese Journal of Mater-nal Health. 2013; 53: 444-450.
Kaneko H, Nomura K, Tanaka N, et al. A prospective study of depression and maternal attachment during pregnancy and one month after delivery. Japanese Journal of Child and Adolescent Psychia-try. 2008; 49(5): 497-508.
Hagino S, Murase S, Kaneko H, et al. The correlates of an-tenatal depression and fetal attachment in expectant fathers and mothers. Japanese Journal of Child and Adolescent Psychiatry. 2006; 47(1): 29-37.
Mohammad KI, Gamble J, Creedy DK. Prevalence and factors associated with the development of antenatal and postnatal de-pression among Jordanian women. Midwifery. 2011; 27: e238-e245. doi: 10.1016/j.midw.2010.10.008
Brockington IF, Oates J, George S, et al. A screening question-naire for mother-infant bonding disorder. Archives of Women’s Men-tal Health. 2001; 3: 133-140. doi: 10.1007/s007370170010
Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: A synthesis of reset lit-erature. Gen Hosp Psychiatry. 2004; 26(4): 289-295. doi: 10.1016/j. genhosppsych.2004.02.006
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