Effect of miscarriage history on maternal-infant bonding during the first year postpartum in the First Baby Study: a longitudinal cohort study

Abstract

BackgroundMiscarriage, the unexpected loss of pregnancy before 20 weeks gestation, may have a negative effect on a mother’s perception of herself as a capable woman and on her emotional health when she is pregnant again subsequent to the miscarriage. As such, a mother with a history of miscarriage may be at greater risk for difficulties navigating the process of becoming a mother and achieving positive maternal-infant bonding with an infant born subsequent to the loss. The aim of this study was to examine the effect of miscarriage history on maternal-infant bonding after the birth of a healthy infant to test the hypothesis that women with a history of miscarriage have decreased maternal-infant bonding compared to women without a history of miscarriage.MethodsWe completed secondary analysis of the First Baby Study, a longitudinal cohort study, to examine the effect of a history of miscarriage on maternal-infant bonding at 1 month, 6 months, and 12 months after women experienced the birth of their first live-born baby. In a sample of 2798 women living in Pennsylvania, USA, we tested our hypothesis using linear regression analysis of Shortened Postpartum Bonding Questionnaire (S-PBQ) scores, followed by longitudinal analysis using a generalized estimating equations model with repeated measures.ResultsWe found that women with a history of miscarriage had similar S-PBQ scores as women without a history of miscarriage at each of the three postpartum time points. Likewise, longitudinal analysis revealed no difference in the pattern of maternal-infant bonding scores between women with and without a history of miscarriage.ConclusionsWomen in the First Baby Study with a history of miscarriage did not differ from women without a history of miscarriage in their reported level of bonding with their subsequently born infants. It is important for clinicians to recognize that even though some women may experience impaired bonding related to a history of miscarriage, the majority of women form a healthy bond with their infant despite this history.

Prenatal Predictors of Maternal-infant Attachment

“…While women with perinatal loss reported more distress than women without perinatal loss in the prenatal period, levels of postnatal maternal-infant attachment did not differ. While this result differs from research that suggests that women with perinatal loss experience poorer maternal-infant attachment with their subsequent child compared to women without loss (Cote-Arsenault & Mahlangu, 1999), results are similar to a study examining women with and without miscarriage history whereby no difference in maternal-infant attachment was identified (Bicking Kinsey, Baptiste-Roberts, Zhu, et al, 2014). A possible reason for this is that women in the study with previous loss were in receipt of a specialized pregnancy after loss service that has been qualitatively reported to be beneficial (Meredith et al, 2017), facilitating the mitigation of potentially suboptimal outcomes (Gaudet et al, 2010;Murphy et al, 2014).…”

Traumatic events: exploring associations with maternal depression, infant bonding, and oxytocin in Latina mothers

“…Therefore, it will be important to conduct a more nuanced examination to determine how specific items may help us understand mother-infant bonding scores, particularly among women who have suffered infant loss. It will also be important to follow women beyond the early postpartum period, as others have done, to help us better understand the evolution of mother-infant bonding in the context of trauma histories involving an infant [ 38 , 39 ].…”

Infertility and Perinatal Loss: When the Bough Breaks

“…Understanding and addressing psychological aspects of perinatal loss is critical because of the psychological reactions of women (grief, depression, anxiety, PTSD, suicide) and the impact on subsequent pregnancies and relationships with partners and surviving siblings [58, 59]. …”