Midwifery · 2026
Biological and psychosocial predictors of mother-infant bonding and emotional availability at six months postpartum among at-risk mothers.
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Devita Sella, Choolani Mahesh, Ng Jamie, Chong Shang Chee, Chee Cornelia Yin Ing, Aayisha, Shah Lubna, Izzuddin Rif'ah Shaik, Chai Loo Soon, Mathews Jancy, Ericksson Johan, Lim Lina, Shorey Shefaly
Аннотация
BACKGROUND: The mother-infant relationship is critical for child development, but may be compromised among mothers facing multiple vulnerabilities. In Singapore, family structures and caregiving norms are rapidly evolving, and at-risk mothers often experience heightened stress and limited social support.
AIM: To understand how psychosocial and biological factors influence mother-infant emotional availability (EA) and bonding.
METHODS: We conducted a cross-sectional study involving 68 at-risk mother-infant dyads drawn from the control arm of a randomized controlled trial in Singapore. Mothers completed validated questionnaires including the Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and What Being the Parent of a Baby Is Like (WPBL). Mother-infant interactions were video-recorded and assessed using the EA Scales. Maternal salivary cortisol was collected as a stress biomarker during the six-month postpartum home visit.
RESULTS: Higher continuous maternal salivary cortisol was significantly associated with poorer mother-infant bonding (β = 0.56, p = 0.045). Compared with the middle tertile, the lowest tertile had higher EA scores (B = 7.16, p = 0.007) and greater odds of emotional availability (OR = 5.28, p = 0.019). Greater parenting satisfaction was associated with stronger bonding (β = -1.31, p < 0.001).
CONCLUSIONS: Biological and psychosocial factors may relate differently to distinct dimensions of the mother-infant relationship among at-risk mothers. Higher salivary cortisol was linked to greater bonding difficulties, whereas emotional availability showed a non-linear pattern across cortisol tertiles. Greater parenting satisfaction was linked to more favourable relational outcomes.
AIM: To understand how psychosocial and biological factors influence mother-infant emotional availability (EA) and bonding.
METHODS: We conducted a cross-sectional study involving 68 at-risk mother-infant dyads drawn from the control arm of a randomized controlled trial in Singapore. Mothers completed validated questionnaires including the Mother-to-Infant Bonding Scale (MIBS), Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), and What Being the Parent of a Baby Is Like (WPBL). Mother-infant interactions were video-recorded and assessed using the EA Scales. Maternal salivary cortisol was collected as a stress biomarker during the six-month postpartum home visit.
RESULTS: Higher continuous maternal salivary cortisol was significantly associated with poorer mother-infant bonding (β = 0.56, p = 0.045). Compared with the middle tertile, the lowest tertile had higher EA scores (B = 7.16, p = 0.007) and greater odds of emotional availability (OR = 5.28, p = 0.019). Greater parenting satisfaction was associated with stronger bonding (β = -1.31, p < 0.001).
CONCLUSIONS: Biological and psychosocial factors may relate differently to distinct dimensions of the mother-infant relationship among at-risk mothers. Higher salivary cortisol was linked to greater bonding difficulties, whereas emotional availability showed a non-linear pattern across cortisol tertiles. Greater parenting satisfaction was linked to more favourable relational outcomes.