Abstract
Introduction
Admission of a newborn to a neonatal intensive care unit (NICU) can be a highly stressful event that affects maternal psychological well-being and disrupts the early maternal-infant bonding relationship. Determining factors that promote maternal-infant bonding among those with a NICU admission is essential for the development of effective interventions.
Methods
Using a longitudinal clinic-based sample of diverse and low-income pregnant women, we examined whether maternal-fetal bonding measured during the second trimester moderated the association between NICU admission and postpartum bonding measured at six months post birth, controlling for demographic characteristics.
Results
Approximately 18% of the sample experienced a NICU admission at birth. NICU admission was associated with lower postpartum bonding (b = -8.74; p < .001, Model 1), whereas maternal-fetal bonding was associated with higher bonding reported at six months postpartum (b = 3.74, p < .001, Model 2). Results of the interaction revealed that women who reported higher maternal-fetal bonding reported higher postnatal bonding regardless of NICU admission status.
Discussion
Because maternal-fetal bonding can be enhanced through intervention, it is a promising target for reducing the risks of NICU admission for the early maternal-infant relationship.
Significance
The experience of a NICU admission is associated with adverse maternal psychological functioning, which in turn has been found to disrupt the early maternal-infant relationship.
AbstractSection What this Study Adds?Maternal-fetal bonding is protective for postnatal bonding when there is a NICU admission. Screening for and enhancing maternal-fetal bonding might be a critical target for intervention.
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Data Availability
The data are available from the corresponding author upon request.
Code Availability
Not applicable.
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Acknowledgements
An earlier version of this paper was presented at the 2021 annual conference of the Society for Research in Child Development. The authors would like to thank the HATCH Project participating clinics and participants for their support and engagement.
Funding
This research was supported in part by the National Institute of General Medical Sciences of the National Institutes of Health (P20GM109097; Jennifer Hays-Grudo, PI). K.M. Shreffler was supported by the Cyndy Ellis-Purgason Endowed Chair in Child Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsors were not involved in the study design, collection, analysis, interpretation of findings, the writing of this report, or the decision to submit the article for publication.
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LC conducted the data analysis and contributed to writing the initial draft of the manuscript. KS collected the data, conceptualized the study, supervised the writing of the initial draft of the manuscript, and revised the manuscript. AQ contributed to writing the initial draft of the manuscript and developing the figure. JP contributed to study recruitment and revised the manuscript. KG contributed to study recruitment and revised the manuscript.
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This study was approved by the authors’ university Institutional Review Boards. The authors certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Ciciolla, L., Shreffler, K.M., Quigley, A.N. et al. The Protective Role of Maternal-Fetal Bonding for Postpartum Bonding Following a NICU Admission. Matern Child Health J 28, 11–18 (2024). https://doi.org/10.1007/s10995-023-03873-4
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DOI: https://doi.org/10.1007/s10995-023-03873-4