Factors influencing interaction between a mother and her premature infant

Davis, Leigh Margaret (2003) Factors influencing interaction between a mother and her premature infant. PhD by Publication, Queensland University of Technology.


Significant relationships have been identified between elements of early parent-infant interactions and later skills or qualities in the child. Generally speaking, sensitive and responsive interactions between a mother and infant during the first year of life tend to be linked with improved child developmental outcomes (Barnard, 1996; Wyly, 1997). Research has examined the influence of infant and family risk factors on parent-infant interaction. Family risk factors including maternal depression can reduce a mother's sensitivity and responsiveness to her infant. Evidence is mounting that mothers of preterm infants experience higher rates of depression than mothers of fullterm infants (e.g. Miles et al., 1999). Although all infants may be vulnerable to the effects of maternal depression, the premature infant is at greater risk due to his/her decreased responsiveness and increased need for appropriate stimulation (Field, 1995).

The purpose of this study was to examine maternal reports of depressive symptomatology and associated variables at two time points following a very preterm birth: at one-month postpartum (Phase 1); and 3 months after infant hospital discharge (Phase 2). Observational data were collected at Phase 2 to explore whether maternal depressive symptoms and associated factors influenced maternal-infant interaction.

A two-phase prospective follow-up design involved surveying mothers of very premature infants (&It; 32weeks) who were admitted to a neonatal intensive care unit (NICU). Multiple measurements were collected at Phase 1 and Phase 2. Mother-infant observational data were collected at Phase 2. The subject population comprised all eligible mothers of very premature infants who were admitted to a 60 bed tertiary referral NICU of a major metropolitan hospital (n=62).

Mothers completed a survey at Phase 1 and Phase 2. The questionnaire contained a number of validated instruments measuring depression, stress, social support and coping. Maternal and infant demographic data were collated from the hospital records. Observational data were collected and coded using the Nursing Child Assessment Feeding Scale (Barnard et al., 1989).

Results indicated that 40% of women reported clinically significant depressive symptomatology at one month postpartum. High maternal stress and low maternal education and support from nursing staff were major factors explaining depression scores. At Phase 2, 17% of women continued to report clinically significant depressive symptomatology. Depression at Phase 1 and maternal stress at Phase 2 were important factors explaining Phase 2 depression scores. An exploratory analysis of the relationship between mother-infant interaction and Phase 1 and Phase 2 variables revealed that the mothers' coping strategies, both in hospital and at home, were important factors in explaining mother-infant interaction.

The results support previous findings that many women suffer stress and depressive symptoms after very premature birth. The results indicate that maternal depression, at one month postnatally, can be predictive of maternal depression at three months after infant hospital discharge and that very premature infants are less responsive interactive partners. These findings highlight possible parenting difficulties particularly during the first year.

This study has contributed to family centered research by highlighting the importance of early postnatal experiences to the longer-term psychological health of mothers and to the mother-infant relationship. Screening mothers of very premature infants for postpartum depression will enable early identification of symptoms and appropriate referral for treatment.

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ID Code: 15826
Item Type: QUT Thesis (PhD by Publication)
Supervisor: Edwards, Helen & Wollin, Judy
Keywords: Infant, premature, preterm, Depression, postpartum, postnatal, Maternal Stress, Mother-infant interaction, Mother child relations, Neonatal Intensive Care (NICU)
Department: Health
Institution: Queensland University of Technology
Copyright Owner: Copyright Leigh Margaret Davis
Deposited On: 03 Dec 2008 03:50
Last Modified: 28 Oct 2011 19:39

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