Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study

Abstract

ObjectivesThe principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour.MethodsOLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS) scale, which includes two behavioural subscales, for the mother (m-ADS) and her infant (i-ADS). Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant’s social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale.ResultsAt discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour.ConclusionsThe ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.

Mind-Mindedness and Parenting Stress: A Cross-Sectional Study in a Cohort of Mothers of 3-Month-Old Full-Term and Preterm Infants

“…The unexpected end of a pregnancy that culminates in a preterm (PT) birth represents a risk for the infant but also for the mother and the dyad. Many PT infants manifest interactive difficulties, and their mothers seem to be less sensitive to infants’ needs compared to full-term (FT) infants’ mothers [ 1 ]. The mothers of PT infants report obstacles in their transition to parenthood, with a detrimental representation of themselves as good and effective mothers and difficulties in seeing the infant as healthy and easy to care for [ 2 , 3 , 4 ].…”

Sensibilização das mães de crianças com microcefalia na promoção da saúde de seus filhos

“…The arrival of a child with some type of disability can generate difficult situations in a family, mainly due to the lack of information about the clinical conditions of the disease (19) . A study that evaluated the mother-infant interaction at the moment of hospital discharge showed that establishing bonding and attachment can be hindered by a lack of opportunities for the mother to interact with her child, causing a disruption in the future relationship of both (20) . Therefore, it is necessary that the health team host the family, providing support for child care and psychological support for mothers and caregivers.…”

Joint observation in NICU (JOIN): study protocol of a clinical randomised controlled trial examining an early intervention during preterm care

“…Parents of preterm neonates face a complex challenge. While they might be responsive to their infant cues, preterm neonates might not be capable of engaging in sustained and responsive interaction, as they tend to be less attentive and reactive due to immaturity, and to show more negative behaviours and emotions, as well as less rewarding interactions than their term-born peers 56 65–67. In parallel, mothers of preterm neonates, who are at risk of experiencing depression, anxiety or post-traumatic disorder,25 35 may not be able to interact as adequately with their child, and could be less sensitive than mothers without mental health symptoms.…”