Risk and protective factors for pre- and postnatal bonding.

Cuijlits I, van de Wetering AP, Endendijk JJ, van Baar AL, Potharst ES, Pop VJM

Infant mental health journal [Infant Ment Health J] 2019 Nov; Vol. 40 (6), pp. 768-785. Date of Electronic Publication: 2019 Aug 20.

2019

Saved in:

Title

Risk and protective factors for pre- and postnatal bonding.

Authors

Cuijlits I, van de Wetering AP, Endendijk JJ, van Baar AL, Potharst ES, Pop VJM

Source

Infant mental health journal [Infant Ment Health J] 2019 Nov; Vol. 40 (6), pp. 768-785. Date of Electronic Publication: 2019 Aug 20.

Abstract

Since disturbances in the mother-child bond increase the risk of negative consequences for child development, it is important to identify risk and protective factors for bonding as well as longitudinal associations. Previous research has used different bonding instruments during pregnancy and the postnatal phase, leading to inconsistent results. In the current study, the same instrument was used during the various phases. In a large, community-based sample (N = 793), general information, feelings of pre- and postnatal bonding (Pre- and Postnatal Bonding Scale), depressive symptoms (Edinburgh Postnatal Depression Scale), and partner support (subscale Tilburg Pregnancy/Postnatal Distress Scale) were measured at both 32 weeks of pregnancy and 8 months postnatally. Partner support was found to be a protective factor for suboptimal pre- and postnatal bonding, as was the engagement with fetal movements for prenatal bonding. High maternal educational level was a risk factor for suboptimal prenatal bonding, as were depressive symptoms for suboptimal postnatal bonding. The associations between most prenatal determinants and postnatal bonding were mediated by prenatal bonding, which underlines the importance of promoting prenatal bonding. Professionals in clinical practice should be aware of partner support, engagement with fetal movements, and postnatal depressive symptoms: All these factors offer opportunities for improving the bonding processes.
(© 2019 Michigan Association for Infant Mental Health.)

Language

English

Journal Info

Publisher: Human Sciences Press] Country of Publication: United States NLM ID: 8007859 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0355 (Electronic) Linking ISSN: 01639641 NLM ISO Abbreviation: Infant Ment Health J Subsets: MEDLINE

MeSH Terms

Object Attachment*, Depression, Postpartum/*psychology , Mother-Child Relations/*psychology, Adult ; Depression/psychology ; Emotions ; Epidemiologic Methods ; Female ; Humans ; Pregnancy ; Protective Factors ; Psychiatric Status Rating Scales ; Risk Factors

Update Code

20250114

Database	MEDLINE
Publication Type	Journal Article; Research Support, Non-U.S. Gov't
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Contributed Indexing	Keywords: Echelle de Lien Pré et Postnatal (PPBS); Escala de Afectividad Pre- y Postnatal (PPBS); Lien prénatal; Mediation; Pre- and Postnatal Bonding Scale (PPBS); Pre- and Postnatal Bondings Scale (PPBS); Risikofaktoren; Schutzfaktoren; facteurs de protection; facteurs de risque; factores de protección; factores de riesgo; lien postnatal; mediación; mediation; médiation; postnatal bonding; postnatale Bindung; prenatal bonding; protective factors; pränatale Bindung; risk factors; unión afectiva postnatal; unión afectiva prenatal; الكلمات الرئيسية: تكوين الروابط قبل الولادة; الوساطة; تكوين الروابط بعد الولادة; عوامل الحماية; عوامل المخاطرة; مقياس تكوين الروابط قبل الولادة وبعدها (PPBS); 仲介; 促進因子; 保護因素; 出産前の絆の形成; 出産前後の絆の形成尺度(PPBS); 出産後の絆の形成; 危険因子; 危險因素; 產前和產後鏈結量表(PPBS); 產前鏈結; 產後鏈結; 調解 Local Abstract: [Publisher, Spanish; Castilian] Dado que las perturbaciones en la unión afectiva entre madre y niño aumentan el riesgo de consecuencias negativas para el desarrollo del niño, es importante identificar los factores de riesgo y de protección de la unión afectiva, así como también las asociaciones longitudinales. La investigación anterior ha utilizado diferentes instrumentos para la unión afectiva durante el embarazo y la fase postnatal, lo que ha llevado a resultados inconsistentes. En el presente estudio, el mismo instrumento se usó durante las diferentes fases. En un grupo muestra grande con base comunitaria (N = 793), se midieron, tanto a las 32 semanas del embarazo como a los ocho meses después del nacimiento, la información general, los sentimientos sobre la unión afectiva pre- y postnatal (Escala de Unión Afectiva Pre- y Postnatal), los síntomas depresivos (Escala de Edimburgo de la Depresión Postnatal), y el apoyo de la pareja (Sub-escala Tilburg sobre el Embarazo / Escala de la Angustia Postnatal). Se detectó el apoyo de la pareja como un factor de protección para la unión afectiva pre- y postnatal por debajo del punto óptimo, lo cual también se dio con respecto a la interacción con los movimientos fetales en la unión afectiva prenatal. El alto nivel de educación materna fue un factor de riesgo para la unión afectiva prenatal sub-óptima, así como los síntomas depresivos lo fueron para la unión afectiva postnatal sub-óptima. Las asociaciones entre la mayoría de los determinantes prenatales y la unión afectiva postnatal fueron mediadas por la unión afectiva prenatal, lo cual subraya la importancia de promover la unión afectiva prenatal. Los profesionales de la práctica clínica deben estar conscientes del apoyo de la pareja, la interacción con los movimientos fetales, y los síntomas depresivos postnatales: todos estos factores ofrecen oportunidades de mejorar los procesos de afectividad. [Publisher, French] Etant donné que les perturbations du lien mère-enfant augmentent le risque de conséquences négatives pour le développement de l'enfant il est important d'identifier les facteurs de risque et les facteurs de protection du lien, ainsi que les associations longitudinales. Jusqu’à présent les recherches ont utilisé divers instruments de lien durant la grossesse et la phase postnatale, menant à des résultats n’étant pas uniformes. Dans cette étude, le même instrument a été utilisé durant les phases multiples. Chez un grand échantillon représentatif de la communauté (N = 793), les renseignements généraux, les sentiments de lien pré- et postnatal (Echelle Pré- et Postnatale) les symptômes dépressifs (Echelle de Dépression Postnatale d'Edinbourg) et le soutien du conjoint (sous-échelle de grossesse Tilburg/Echelle de Détresse Postnatale) ont été mesurés à la fois à 32 semaines de grossesse et à huit mois postnatalement. Le soutien du conjoint s'est avéré être une facteur de protection pour le lien sous-optimal pré- et postnatal, tout comme l’était le fait de s'engager avec les mouvements du foetus pour le lien prénatal. Un niveau élevé d’éducation chez la mère était un facteur de risque de lien prénatal sous-optimal, tout comme l’étaient des symptômes dépressifs pour le lien sous-optimal postnatal. Les associations entre la plupart des déterminants prénataux et le lien postnatal étaient toutes influencées par le lien prénatal, ce qui souligne l'important de la promotion du lien prénatal. Les professionnels en pratique clinique devraient être vigilants quant au soutien du partenaire, au fait de s'engager avec les mouvements du foetus et aux symptômes dépressifs postnataux: tous ces facteurs offrent des possibilités d'amélioration des processus de lien. [Publisher, German] Risiko- und Schutzfaktoren für prä- und postnatale Bindung Da Störungen der Mutter-Kind-Bindung das Risiko negativer Konsequenzen in der kindlichen Entwicklung erhöhen, ist es wichtig, Risiko- und Schutzfaktoren für Bindung sowie längsschnittliche Zusammenhänge zu ermitteln. Vorrangegangene Studien verwendeten während der Schwangerschaft und in der postnatalen Phase unterschiedliche Messinstrumente für Bindung, was zu inkonsistenten Ergebnissen führte. In der vorliegenden Studie wurde während der verschiedenen Phasen dasselbe Messinstrument verwendet. In einer großen Bevölkerungsstichprobe (N = 793) wurden allgemeine Informationen, pre- und postnatale Bindungsgefühle (Pre- and Postnatal Bonding Scale), depressive Symptome (Edinburgh Postnatal Depression Scale) und Unterstützung durch die Partnerin (subscale Tilburg Pregnancy/Postnatal Distress Scale) in der 32. Schwangerschaftswoche und 8 Monate nach der Geburt erhoben. Unterstützung durch dendie Partnerin wurde als Schutzfaktor vor suboptimaler prä- und postnataler Bindung ermittelt. Das Eingehen auf fetale Bewegungen wurde als Schutzfaktor vor suboptimaler pränataler Bindung ermittelt. Ein hoher mütterlicher Bildungsstand wurde als Risikofaktor für suboptimale pränatale Bindung und depressive Symptome als Risikofaktor für suboptimale postnatale Bindung ermittelt. Die Zusammenhänge zwischen den meisten pränatalen Bestimmungsfaktoren und postnataler Bindung wurden durch pränatale Bindung mediiert. Klinisch praktizierendes Fachpersonal sollte sich der Bedeutung bewusst sein, die von Unterstützung durch dendie Partner*in, dem Eingehen auf fetale Bewegungen und postnataler depressiver Symptomatik ausgehen kann. All diese Faktoren bieten Möglichkeiten zur Verbesserung von Bindungsprozessen. [Publisher, Japanese] 出産前後の絆の形成における危険因子と保護的因子母子の絆における阻害は、子どもの成長に悪い結果をもたらすリスクを増大するため、他の長期的な関連因子と同様、絆形成における危険因子と保護的因子を同定することが重要である。これまでの研究では妊娠期と出産後の期間に対し、絆形成に関する異なる評価法を用いており、そのために一貫性のない結果をもたらしていた。本研究では、異なる時期に対して同じ評価法が用いられた。ある大規模な地域に根差した母集団 (N=793) において、妊娠 32 週と出産後 8 ヶ月の時点における全般的な情報、出産前後の絆形成にまつわる感情 (出産前後の絆形成尺度) 、抑うつ症状 (エジンバラ産後鬱尺度) 、パートナーの協力 (Tilberg 妊娠/出産後ストレス尺度) が評価された。パートナーの協力は、出産前後の絆形成のための保護的因子となり、出産前の胎動による関わりも同様であった。母親の高い教育水準は出産前の絆形成の危険因子となり、出産後の抑うつ症状も同様であった。ほとんどの出産前の決定因子と出産後の絆形成の関連は、出産前の絆形成による影響を受け、そのことは出産前の絆形成を促進する重要性を示す。臨床現場の専門家は、パートナーの協力、胎動による関わり、産後の抑うつ症状に留意すべきである:これらすべての因子は、絆形成のプロセスを改善する機会をもたらす。. [Publisher, Chinese] 產前和產後鏈結的風險和保護因素由於母子關係的紊亂增加負面影響兒童發育的風險, 因此必須確定鏈結的風險和保護因素, 以及縱向聯繫。以往的研究在產前和產後使用不同的鏈結測量工具, 導致結果不一。本研究在不同階段中使用相同的測量工具。以一個大型社區樣本 (N = 793) , 在妊娠 32 周和出生 8 個月後, 測量一般信息丶產前和產後鏈結的感覺 (產前和產後鏈結量表)丶抑鬱症狀 (愛丁堡產後抑鬱量表) 和夥伴支持 (子量表 Tilburg 妊娠/產後困擾量表)。發現夥伴支持及產前鏈結胎兒運動的參與, 是產前和產後不理想鏈結的保護因素。高產婦教育水平是產前不理想鏈結的一個風險因素, 抑鬱症狀也是風險因素。大多數產前決定因素與產後鏈結的關聯是通過產前鏈結合來介導的, 這突出了促進產前鏈結的重要性。臨床專業人員應該了解伴侶支持丶參與胎兒運動以及產後抑鬱症狀:這些因素都為改善鏈結提供了機會。. [Publisher, Arabic] عوامل المخاطرة والعوامل الوقائية في تكوين الروابط قبل وبعد الولادة بما أن الاضطرابات في رابطة الأم والطفل تزيد من خطر العواقب السلبية على نمو الطفل، فمن المهم تحديد عوامل الخطر والحماية لتكوين الروابط، فضلا عن الارتباطات الطولية. وقد استخدمت البحوث السابقة أدوات ترابط مختلفة أثناء الحمل ومرحلة ما بعد الولادة، مما أدى إلى نتائج غير متسقة. وفي الدراسة الحالية، استُخدم نفس المقياس خلال المراحل المختلفة. في عينة مجتمعية كبيرة (N = 793)، تم قياس المعلومات العامة، ومشاعر تكوين الروابط قبل الولادة وبعدها (مقياس الترابط قبل الولادة وبعدها)، وأعراض الاكتئاب (مقياس أدنبرة للاكتئاب بعد الولادة)، ودعم الشريك (مقياس تيلبورغ للحمل / مقياس الضيق بعد الولادة) في كل من الحمل 32 أسبوعا وثمانية أشهر بعد الولادة. وتبين أن دعم الشريك عامل وقائي لتكوين الروابط قبل الولادة وبعدها، وكذلك التفاعل مع حركات الجنين لتكوين الروابط قبل الولادة. وكان ارتفاع مستوى تعليم الأمهات عاملا من عوامل الخطر بالنسبة للترابط دون المستوى الأمثل قبل الولادة، وكذلك أعراض الاكتئاب للارتباط دون المستوى الأمثل بعد الولادة. وقد كان تكوين الروابط قبل الولادة عاملا وسيطا بين معظم محددات ما قبل الولادة وتكوين الروابط بعد الولادة ، مما يؤكد أهمية تعزيز الترابط قبل الولادة. ويجب أن يدرك المهنيون في الممارسة الإكلينيكية أهمية دعم الشريك، والتفاعل مع حركات الجنين، وأعراض الاكتئاب بعد الولادة: كل هذه العوامل توفر فرصا لتحسين عمليات تكوين الروابط .
DOI	10.1002/imhj.21811
PMID	31430393

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