Factors associated with mother-to-infant bonding difficulties without prior postnatal depression at 1 and 6 months after childbirth: the Japan Environment and Children's Study (JECS).

PURPOSE: To identify factors associated with mother-to-infant bonding difficulties (MIBD) in mothers without prior postnatal depression and to elucidate the prevalence.

METHODS

A total of 64,938 mother-child pairs who had registered between 2011 and 2014 in a nationwide birth cohort study called the Japan Environment and Children's Study (JECS) were analysed. MIBD was assessed using the Mother-to-Infant Bonding Scale Japanese version (MIBS-J). Prior postnatal depression was defined as an Edinburgh Postnatal Depression Scale score ≥ 9 at both 1 month and 6 months postpartum, and mothers who met this criterion were excluded. Mothers with a MIBS-J score ≥ 5 were considered to have MIBD. Cut-offs of ≥ 3 were set for MIBS-J subscale scores for lack of affection (LA)and anger/rejection (AR). We set 30 factors as exposures, and data were subjected to logistic regression analysis.

RESULTS

The prevalence of MIBD, LA, and AR among those without prior postpartum depression was 7.7%, 3.9%, and 11.7%, respectively. The most strongly associated factors were 'feeling difficulty in holding the baby when they were cranky or arching their back' (AOR: 3.45 [2.96-4.03]) and 'negative feelings towards the pregnancy' (AOR: 2.42 [2.20-2.65]). 'High social support' (AOR: 0.45 [0.41-0.49]) was strongly associated with the absence of MIBD without prior postnatal depression.

CONCLUSIONS

In this study, the prevalence of MIBD among women without prior postnatal depression was 7.7%. MIBD without prior postnatal depression was strongly associated with 'difficulty holding the baby when they were cranky or arching their back', 'low social support', and 'negative feelings towards the pregnancy'.