Neonatal Intensive Care Unit Admittance and Postpartum Bonding: The Moderating Role of Maternal-Fetal Bonding

• In Event: Poster Session 13
  In Poster Session: PS 13 Topic - Parenting & Parent-Child Relationships

Abstract

BACKGROUND Newborn admission to a Neonatal Intensive Care Unit (NICU) is a common experience, though often unexpected. Each year, approximately 1.5 million newborns (10–15% of all newborns) are admitted to the NICU in the U.S. (Harrison & Goodman, 2015). A considerable body of research has documented negative psychological consequences for parents with newborns in the NICU, including increased stress, depression, and anxiety (Alkozei et al., 2014; Bonacquisti et al., 2019; Lefkowitz et al., 2010). In part, these outcomes are due to disruptions in mother-infant bonding (Kinsey & Hupcey, 2013) and are strongly correlated with maternal caregiving (Coyl et al., 2002). Therefore, exploration of modifiable factors that can buffer the adverse impacts of NICU admission on the early mother-infant relationship is critical. Maternal-fetal bonding (MFB), referring to the affectionate feelings a mother develops for her baby during pregnancy (Brandon et al., 2009; Cranley, 1981; Müller & Mercer, 1993), is one such factor. MFB serves as a direct indicator for maternal sensitivity and postpartum mother-infant bonding (Maas et al., 2013; 2016; Rossen et al., 2017) and is responsive to interventions (de Jong-Pliej et al., 2013; Nishikawa & Sakakibara, 2013; Sandbrook & Adamson-Macedo, 2004; Shreffler et al., 2019). In this study, we used a longitudinal sample of women recruited during pregnancy to examine how NICU admission was associated with postpartum bonding at six months postpartum and whether MFB moderated the association.
METHODS Data for the current study came from a longitudinal, urban, clinic-based cohort study involving 177 pregnant women (ages 16-38) recruited in 2017-2018. The participating clinics serve a racially diverse and underserved patient population. The sample for the current study was restricted to the 116 participants who responded to the first six survey waves (first trimester through six months postpartum). Demographic variables were measured at the first assessment. MFB was measured at the second assessment with the Prenatal Attachment Inventory (Müller & Mercer, 1993; Siddiqui et al., 1999), and NICU admittance was measured approximately one month after birth in the fourth assessment. Postpartum bonding (Brockington et al., 2006) was measured at the six-month postpartum assessment.
RESULTS Multiple regression analyses found that having a newborn admitted to the NICU at birth was associated with lower levels of postpartum bonding. Higher levels of MFB, however, was associated with higher levels of bonding at six months postpartum. These associations were unchanged when controlling for race/ethnicity, education, economic hardship, and union status. An interaction between NICU admission and MFB was added to the final model and also was significantly associated with postpartum bonding. See Table 1 for the regression results and Figure 1 for the interaction depicted visually.
CONCLUSION Although NICU admission was associated with significant risk for lower postpartum bonding, higher levels of MFB served as a protective factor, such that postpartum bonding scores were equivalent with those of non-NICU newborns. Because prenatal bonding can be enhanced through intervention, it is a promising target to reduce the risks for postpartum bonding that exist for families who experience the NICU with their newborns.

Authors

• DC Hegdale, Oklahoma State University - Tulsa
  Presenting Author

• Ashley N Quigley, Oklahoma State University - Stillwater
  Non-Presenting Author

• Tara Wyatt, Oklahoma State University - Tulsa
  Non-Presenting Author

• Lucia Ciciolla, Oklahoma State University - Stillwater
  Non-Presenting Author

• Karina M. Shreffler, University of Oklahoma Health Sciences Center
  Non-Presenting Author