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Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby).
BMC Psychiatry. 2020 06 15; 20(1):300.BP

Abstract

BACKGROUND

Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant's signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up.

METHODS

This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up.

RESULTS

A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby's signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small.

CONCLUSIONS

The results indicate that the NBO-group learned more than the comparison group about reading their child's signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample.

TRIAL REGISTRATION

ClinicalTrials, NCT02538497, Registered 2 September 2015.

Authors+Show Affiliations

Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. ragnhild.s.hoifodt@uit.no.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway.Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway. Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. Division of Child and Adolescent Health, University Hospital of Northern Norway, Tromsø, Norway.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.Department of Social Science, Faculty of Health and Social Science, Western Norway University of Applied Sciences, Bergen, Norway. Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway.Department of Social Science, Faculty of Health and Social Science, Western Norway University of Applied Sciences, Bergen, Norway. Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre AS, Bergen, Norway.Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.Regional Centre for Child and Adolescent Mental Health East and South, Oslo, Norway.Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32539729

Citation

Høifødt, Ragnhild Sørensen, et al. "Newborn Behavioral Observation, Maternal Stress, Depressive Symptoms and the Mother-infant Relationship: Results From the Northern Babies Longitudinal Study (NorBaby)." BMC Psychiatry, vol. 20, no. 1, 2020, p. 300.
Høifødt RS, Nordahl D, Landsem IP, et al. Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby). BMC Psychiatry. 2020;20(1):300.
Høifødt, R. S., Nordahl, D., Landsem, I. P., Csifcsák, G., Bohne, A., Pfuhl, G., Rognmo, K., Braarud, H. C., Goksøyr, A., Moe, V., Slinning, K., & Wang, C. E. A. (2020). Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby). BMC Psychiatry, 20(1), 300. https://doi.org/10.1186/s12888-020-02669-y
Høifødt RS, et al. Newborn Behavioral Observation, Maternal Stress, Depressive Symptoms and the Mother-infant Relationship: Results From the Northern Babies Longitudinal Study (NorBaby). BMC Psychiatry. 2020 06 15;20(1):300. PubMed PMID: 32539729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby). AU - Høifødt,Ragnhild Sørensen, AU - Nordahl,Dag, AU - Landsem,Inger Pauline, AU - Csifcsák,Gábor, AU - Bohne,Agnes, AU - Pfuhl,Gerit, AU - Rognmo,Kamilla, AU - Braarud,Hanne C, AU - Goksøyr,Arnold, AU - Moe,Vibeke, AU - Slinning,Kari, AU - Wang,Catharina Elisabeth Arfwedson, Y1 - 2020/06/15/ PY - 2019/11/08/received PY - 2020/05/13/accepted PY - 2020/6/17/entrez PY - 2020/6/17/pubmed PY - 2020/12/22/medline KW - Intervention KW - Mother-infant relationship KW - Newborn behavioral observation KW - Parenting stress KW - Postpartum depression SP - 300 EP - 300 JF - BMC psychiatry JO - BMC Psychiatry VL - 20 IS - 1 N2 - BACKGROUND: Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant's signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up. METHODS: This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up. RESULTS: A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby's signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small. CONCLUSIONS: The results indicate that the NBO-group learned more than the comparison group about reading their child's signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample. TRIAL REGISTRATION: ClinicalTrials, NCT02538497, Registered 2 September 2015. SN - 1471-244X UR - https://www.unboundmedicine.com/medline/citation/32539729/Newborn_Behavioral_Observation_maternal_stress_depressive_symptoms_and_the_mother_infant_relationship:_results_from_the_Northern_Babies_Longitudinal_Study__NorBaby__ L2 - https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02669-y DB - PRIME DP - Unbound Medicine ER -