074 - Investigating the Effects of Maternal Bonding and Parental Stress on Neurodevelopmental Outcomes in Very Low Birth Weight Infants Up to Age Two During the COVID-19 Pandemic

Publication Number: 74.5249

YaChi Hsu, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan (Republic of China); Ming-Chih Lin, Natioanl Chung Hsing University, Taichung, Taichung, Taiwan (Republic of China); Kuan-Ying Lai, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan (Republic of China)

Background: The experience of premature birth has consequences not only for the child and the parents as separate entities, but also for their relationship as it develops during a critical period. Studies on parent-infant bonding have demonstrated that better bonding may have a positive effect on further neonatal social development.

Objective: However, there is little empirical evidence, especially with respect to prospective longitudinal studies. This study aimed to explore the impact of these restrictions on parent-infant bonding, as well as parenting stress, and the subsequent development of the infants during the COVID-19 pandemic.

Design/Methods: For this cohort study, we enrolled very-low-birth-weight infants born during the COVID-19 pandemic period in a single medical center. In Taiwan, the hospitals were subjected to varying levels of government-imposed visiting restrictions, and we utilized social media to assist those restricted. We divided participants into two groups: those who had visiting restrictions (defined as unable to visit the baby for more than half of the hospitalization period) and the rest. Parents completed the Mother-Infant Bonding Inventory (MIBI) and modified Parenting Stress Index (mPSI) twice: once before discharge and again at the outpatient visit. To assess neurodevelopmental outcomes, the Bayley Scales, 3rd edition was arranged when the infants reached the corrected age (CA) of one and two years. We compared the data between groups and utilized multiple linear regression models to analyze the effects of visiting restrictions on both parents and preterm infants.

Results: In this study, a total of 43 infant-parent dyads were included (figure 1). Regardless of before or after discharge, and irrespective of the mother’s or the father’s assessment, the scores of each factor and the total scores of the MIBI were higher in the non-restriction group. Statistically significant results were observed for the 'confidence in reciprocity' factor and the total score among mothers, the 'proximity' factor among parents before discharge, and the 'commitment' factor among mothers after discharge. The scores in the mPSI were lower in the non-restriction group in “acceptability” domain. Although there was no difference in the Bayley scores between the restriction and non-restriction groups, the depression domain in mPSI from mothers affect the children’s neurodevelopment at one and two years of CA. See figure 2.

Conclusion(s): Visiting restrictions led to impaired parent-infant bonding and increased parental stress. Maternal depression can impact the neurodevelopment in preterm infants.

flowchart


Depression domain in mPSI affected the Bayley scores.
Poor maternal adaptation stress in the depression subscale before the infants’ discharge had relationship with poor Bayley scores. (T1) Before discharge. (T2) After discharge. The y-axis is the composite scores; part a, b, and c represent the cognitive, language and motor subscales. The red and blue box are the fair and poor maternal adaptation in the depression subscale in mPSI. *p < 0.05