Apego en el postparto precoz: comparación entre madres de neonatos ingresados en el Servicio de Obstetricia y en la Unidad de Cuidados Intensivos Neonatales

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Abstract

Resumen Introducción el apego materno es el conjunto de conductas y vínculos que la madre establece en torno al recién nacido. El ingreso en la Unidad de Cuidados Intensivos Neonatales supone una barrera en el establecimiento de estos primeros lazos. Objetivo el principal objetivo del presente estudio es comparar el grado de apego valorando dicha separación, así como identificar aquellas variables que podrían influir en su establecimiento. Material y métodos un total de 82 madres, divididas en dos grupos (O-U), participaron en este estudio ex postfacto comparativo causal mediante la cumplimentación del cuestionario Maternal Attachment Inventory, la entrevista y la revisión de la historia clínica. Resultados se encontraron diferencias estadísticamente significativas en la puntuación MAI entre madres del Grupo Obstetricia (99'67) y del Grupo UCIN (91'64), del mismo modo se señaló la edad gestacional y la alimentación como factores influyentes. Discusión y conclusión la separación tras el ingreso en la Unidad de Cuidados Intensivos Neonatales dificulta el establecimiento de los primeros vínculos maternos. Es necesario valorar los diferentes factores que influyen en esta situación y realizar futuras intervenciones para mejorar la relación materno-filial.

Translated abstract

Abstract Introduction Maternal attachment is the set of behaviors and links established around to the mother and the newborn. Admission to the Neonatal Intensive Care Unit (NICU) is a barrier in establishing these early ties. Objective The main objective of this study is compare the degree of maternal attachment in the Neonatal Intensive Care Unit, and it identify the variables that could influence on his establishment. Material and methods 82 mothers, divided into two groups, participated in this causal comparative study by carry out the questionnaire Maternal Attachment Inventory (MAI), the interview and review of medical history. Results There are significant differences in MAI scores between mothers of Obstetrics Group (99'67) and NICU Group (91'64). Gestational age and feeding are influential factors. Discussion and conclusion Separation hinders the establishment of the first maternal ties. It is necessary to assess the factors that influence in this situation and it plan future interventions to improve maternal-child relationship.

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Prematurity, maternal stress and mother-child interactions.

Carole Muller-Nix, Margarita Forcada-Guex, Blaise Pierrehumbert … (2004)

Previous studies have shown that premature birth and the immaturity of the child can affect the quality of the parent-child relationship. The present study examines the relationship between maternal and infant interactional behavior over time and infant perinatal risk factors as well as maternal perinatal recollected traumatic experience. Few studies have explored the relationship between maternal stress and the quality of parent-infant interaction. Mother-child interaction was recorded at 6 and 18 months of infant's age, in a population of 47 preterm infants (GA<34 weeks) and 25 full-term infants, born in 1998, during a play interaction. According to the Care Index, sensitivity, control and unresponsiveness have been used to code maternal interactional characteristics, and cooperation, compliance-compulsiveness, difficulty and passivity have been used to code the infant's interactional characteristics. The level of maternal stress was evaluated with the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ), and the infant's perinatal risk factors were assessed with the Perinatal Risk Inventory (PERI). Mothers of high-risk infants, as well as mothers that had experienced traumatic stress in the perinatal period, were less sensitive and more controlling at 6 months. The interactional behavior of the preterm infant was different from that of the full-term infant at 18 months of age, and was correlated with maternal traumatic stress but not with perinatal risk factors. These results underline the importance of maternal traumatic experience related to premature birth and its potential long lasting influence on mother-child interactional behavior.

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A meta-analytic study of predictors of maternal-fetal attachment.

Adela Yarcheski, Noreen E Mahon, Thomas J Yarcheski … (2009)

To identify predictors of maternal-fetal attachment (MFA) through a comprehensive review of the literature, and to use quantitative meta-analysis to determine the magnitude of the relationship between each predictor and MFA. The literature reviewed included 183 studies of MFA, published and unpublished, between 1981 and 2006. Seventy-two studies met the inclusion criteria and yielded 14 predictors of MFA. A meta-analysis was performed on each of the 14 predictors in relation to MFA. The results indicated that gestational age had a moderate to substantial effect size. Two predictors (social support and prenatal testing) had moderate effect sizes; 10 predictors (anxiety, self-esteem, depression, planned pregnancy, age, parity, ethnicity, marital status, income, and education) had low effect sizes. High-risk pregnancy had a trivial effect size. The most powerful predictors of MFA using meta-analysis were identified to direct future research and evidence-based practice.