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)

Abstract

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’.