The Link Between Maternal Postpartum Emotional Distress and Infant Early Social Withdrawal Symptoms in Full-term and Preterm Infants Among the Bedouin Society: A Longitudinal Study

• In Event: Mother-Child Relationships and Early Child Development in Different Cultures

Abstract

Introduction: Mothers of preterm infants are at high risk for postpartum depression and anxiety (i.e., postpartum emotional distress). This risk is further increased for women from ethnic minority groups, such as the Bedouins-Arabs, due to cultural stressors, such as low socioeconomic status, restricted access to health providers and language difficulties. This is a cause for concern because extensive research indicated that mothers’ postpartum emotional distress has a strong effect on infants’ development. Previous work has demonstrated that the caregivers’ emotional distress might affect the infant emotional state by demonstrating withdrawn behavior not only to the caregiver but also to others (Guedeney, 2007). In the current study we intend to further examine the link between change in maternal emotional distress over the first 6 months after birth and child’s social withdrawal, by using the Alarm Distress baby Scale (ADBB; Guedeney and Fermanian, 2001), to assess early infants’ withdrawn, while focusing on an understudied non-Westernized culture.
Hypotheses: We first hypothesized that prematurity, maternal emotional distress’ over the first 6 months postpartum, and the mother-child interaction would each, predict infant social withdrawal. Then, a sequential mediation model was proposed and tested. Specifically, first, we hypothesized that prematurity would be related to infant social withdrawal at age 12 months. Then, we further hypothesized that this association would be mediated by the changes in maternal emotional distress over the first six months and, subsequently through mother-child interaction at age 6 months
Sample: One hundred and five Bedouin mothers and their preterm (n = 48) and full-term (n = 57) infants participated in this study. Infants and their mothers were recruited shortly after birth (T1) in the maternity ward or neonatal intensive care unit at Soroka Medical Center and were followed up at ages 6 months (T2) and 12 (T3) months.
Methods: Mothers completed questionnaires on maternal postpartum depression and maternal level of anxiety at T1, T2, and T3. Additionally, mother-child interaction was assessed during free play interaction at T2 and coded using the Emotional Availability Scale, and infant social withdrawal was assessed during T3, and coded using the Alarm distress baby behavior.
Results: Findings indicated that changes in both maternal emotional distress during the first six months postpartum and mother-child interaction (i.e., mothers’ sensitivity, non-hostility, and non-intrusiveness), as assessed at T2, predicted infant social withdrawal at T3. Furthermore, the overall indirect effect suggested that maternal non-hostility was a main variable mediating the link between prematurity and infant social withdrawal (see figure 1).
Conclusions: Our findings provide evidence that changes in maternal emotional distress during the first six months after birth are related to the infant social withdraw later. Moreover, although mothers of preterm and full-term infants did not differ as a group in their parenting behaviors, mothers of premature infants showed higher levels of non-hostility (i.e., less hostility) when interacting with their premature infants. These findings highlight the importance of better understanding maternal behaviors, particularly non-hostility, when parenting a premature infant. The importance of a culturally sensitive assessment and interpretation of the results are discussed.

Authors

• Shuaa Assal Zrike, Ben-Gurion university
  Presenting Author

• Naama Atzaba-Poria, Ben-Gurion University of the Negev
  Non-Presenting Author