The influence of antenatal imaging on prenatal bonding in uncomplicated pregnancies: a mixed methods analysis.
Attachment
Bonding
Fetal
Imaging
MRI
Parent
Ultrasound
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
11 Apr 2024
11 Apr 2024
Historique:
received:
01
08
2023
accepted:
30
03
2024
medline:
12
4
2024
pubmed:
12
4
2024
entrez:
11
4
2024
Statut:
epublish
Résumé
Prenatal bonding describes the emotional connection expectant parents form to their unborn child. Research acknowledges the association between antenatal imaging and enhanced bonding, but the influencing factors are not well understood, particularly for fathers or when using advanced techniques like fetal magnetic resonance imaging (MRI). This study aimed to identify variables which may predict increased bonding after imaging. First-time expectant parents (mothers = 58, fathers = 18) completed a two-part questionnaire (QualtricsXM™) about their expectations and experiences of ultrasound (n = 64) or fetal MRI (n = 12) scans in uncomplicated pregnancies. A modified version of the Prenatal Attachment Inventory (PAI) was used to measure bonding. Qualitative data were collected through open-ended questions. Multivariate linear regression models were used to identify significant parent and imaging predictors for bonding. Qualitative content analysis of free-text responses was conducted to further understand the predictors' influences. Bonding scores were significantly increased after imaging for mothers and fathers (p < 0.05). MRI-parents reported significantly higher bonding than ultrasound-parents (p = 0.02). In the first regression model of parent factors (adjusted R Antenatal imaging provides reassurance of fetal development which affirms parents' emotional investment in the pregnancy and supports the growing connection. Imaging professionals are uniquely positioned to provide parent-centred experiences which may enhance parental excitement and facilitate bonding.
Sections du résumé
BACKGROUND
BACKGROUND
Prenatal bonding describes the emotional connection expectant parents form to their unborn child. Research acknowledges the association between antenatal imaging and enhanced bonding, but the influencing factors are not well understood, particularly for fathers or when using advanced techniques like fetal magnetic resonance imaging (MRI). This study aimed to identify variables which may predict increased bonding after imaging.
METHODS
METHODS
First-time expectant parents (mothers = 58, fathers = 18) completed a two-part questionnaire (QualtricsXM™) about their expectations and experiences of ultrasound (n = 64) or fetal MRI (n = 12) scans in uncomplicated pregnancies. A modified version of the Prenatal Attachment Inventory (PAI) was used to measure bonding. Qualitative data were collected through open-ended questions. Multivariate linear regression models were used to identify significant parent and imaging predictors for bonding. Qualitative content analysis of free-text responses was conducted to further understand the predictors' influences.
RESULTS
RESULTS
Bonding scores were significantly increased after imaging for mothers and fathers (p < 0.05). MRI-parents reported significantly higher bonding than ultrasound-parents (p = 0.02). In the first regression model of parent factors (adjusted R
CONCLUSIONS
CONCLUSIONS
Antenatal imaging provides reassurance of fetal development which affirms parents' emotional investment in the pregnancy and supports the growing connection. Imaging professionals are uniquely positioned to provide parent-centred experiences which may enhance parental excitement and facilitate bonding.
Identifiants
pubmed: 38605314
doi: 10.1186/s12884-024-06469-0
pii: 10.1186/s12884-024-06469-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
265Subventions
Organisme : College of Radiographers
ID : DF017
Organisme : City, University of London
ID : Research Sustainability Fund
Informations de copyright
© 2024. The Author(s).
Références
National Institute for Health and Care Excellence. Overview | Antenatal care for uncomplicated pregnancies | Guidance | NICE. 2019. https://www.nice.org.uk/guidance/cg62 .
Oates C, Taylor P. Helping expectant mothers understand inadequate ultrasound images. Ultrasound. 2016;24:142–6.
pubmed: 27867406
pmcid: 5105361
doi: 10.1177/1742271X16651901
Aertsen M, Diogo MC, Dymarkowski S, Deprest J, Prayer D. Fetal MRI for dummies: what the fetal medicine specialist should know about acquisitions and sequences. Prenat Diagn. 2020;40:6–17.
pubmed: 31618472
doi: 10.1002/pd.5579
Leithner K, Pornbacker S, Assem-Hilger E, Krampl E, Ponocny-Seliger E, Prayer D. Psychological reactions in women undergoing fetal magnetic resonance imaging. Obstet Gynecol. 2008;11:396–402.
doi: 10.1097/AOG.0b013e3181610281
Brugger PC, Prayer D. Actual imaging time in fetal MRI. Eur J Radiol. 2012;81:e194–6.
pubmed: 21345632
doi: 10.1016/j.ejrad.2011.01.115
Skelton E, Webb R, Malamateniou C, Rutherford M, Ayers S. The impact of antenatal imaging on parent experience and prenatal attachment: a systematic review. J Reprod Infant Psychol. 2022;00:1–23.
Walsh TB, Tolman RM, Singh V, Davis MM, Davis RN. Expectant fathers’ presence at prenatal ultrasounds: an opportunity for engagement. Soc Work Res. 2017;41:181–5.
doi: 10.1093/swr/svx014
Muller M, Mercer R. Development of the prenatal attachment inventory. West J Nurs Res. 1993;15:199–215.
pubmed: 8470375
doi: 10.1177/019394599301500205
Redshaw M, Martin C. Babies, ‘bonding’ and ideas about parental ‘attachment.’ J Reprod Infant Psychol. 2013;31:219–21.
doi: 10.1080/02646838.2013.830383
Glover V, Capron L. Prenatal parenting. Curr Opin Psychol. 2017;15:66–70.
pubmed: 28813271
doi: 10.1016/j.copsyc.2017.02.007
Trombetta T, Giordano M, Santoniccolo F, Vismara L, Della Vedova AM, Rollè L. Pre-natal attachment and parent-to-infant attachment: A systematic review. Front Psychol. 2021;12:1–17.
doi: 10.3389/fpsyg.2021.620942
Ramchandani PG, Domoney J, Sethna V, Psychogiou L, Vlachos H, Murray L. Do early father-infant interactions predict the onset of externalising behaviours in young children? Findings from a longitudinal cohort study. J Child Psychol Psychiatry Allied Discip. 2013;54:56–64.
doi: 10.1111/j.1469-7610.2012.02583.x
Borg Cunen N, Jomeen J, Borg Xuereb R, Poat A. A narrative review of interventions addressing the parental–fetal relationship. Women and Birth. 2017;30:e141–51.
pubmed: 27884654
doi: 10.1016/j.wombi.2016.11.005
Borg Cunen N, Jomeen J, Poat A, Borg XR. ‘A small person that we made’ - Parental conceptualisation of the unborn child: A constructivist grounded theory. Midwifery. 2022;104:103198.
pubmed: 34800776
doi: 10.1016/j.midw.2021.103198
Roberts J. ‘Wakey wakey baby’: Narrating four-dimensional (4D) bonding scans. Sociol Heal Illn. 2012;34:299–314.
doi: 10.1111/j.1467-9566.2011.01345.x
Reed K, Kochetkova I, Molyneux-Hodgson S. ‘You’re looking for different parts in a jigsaw’: foetal MRI (magnetic resonance imaging) as an emerging technology in professional practice. Sociol Heal Illn. 2016;38:736–52.
doi: 10.1111/1467-9566.12398
NHS Fetal Anomaly Screening Programme. NHS Fetal anomaly screening programme handbook. 2021. https://phescreening.blog.gov.uk/2021/07/23/new-fasp-handbook/ .
Lie M, Graham R, Robson S, Griffiths P. “He looks gorgeous” - iuMR images and the transforming of foetal and parental identities. Sociol Health Illn. 2019;41:360–77.
pubmed: 30450603
doi: 10.1111/1467-9566.12831
Lagarto A, Duaso MJ. Fathers’ experiences of fetal attachment: A qualitative study. Infant Ment Health J. 2022;43:328–39.
pubmed: 34936111
doi: 10.1002/imhj.21965
Hodgson S, Painter J, Kilby L, Hirst J. The experiences of first-time fathers in perinatal services: Present but invisible. Healthc. 2021;9:1–12.
doi: 10.3390/healthcare9020161
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbrouckef JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Lancet. 2007;370:1453–7.
doi: 10.1016/S0140-6736(07)61602-X
Skelton E, Drey N, Rutherford M, Ayers S, Malamateniou C. Electronic consenting for conducting research remotely: A review of current practice and key recommendations for using e-consenting. Int J Med Inform. 2020;143:104271.
pubmed: 32979650
pmcid: 7487205
doi: 10.1016/j.ijmedinf.2020.104271
Ranjbar F, Warmelink JC, Gharacheh M. Prenatal attachment in pregnancy following assisted reproductive technology: a literature review. J Reprod Infant Psychol. 2020;38:86–108.
pubmed: 31852259
doi: 10.1080/02646838.2019.1705261
Armstrong DS. Impact of prior perinatal loss on subsequent pregnancies. J Obstet Gynecol Neonatal Nurs. 2004;33:765–73.
pubmed: 15561665
doi: 10.1177/0884217504270714
Skelton E, Smith A, Harrison G, Rutherford M, Ayers S, Malamateniou C. The effect of the COVID-19 pandemic on UK parent experience of pregnancy ultrasound scans and parent-fetal bonding: A mixed methods analysis. PLoS One. 2023;18(6):e0286578.
pubmed: 37267279
pmcid: 10237394
doi: 10.1371/journal.pone.0286578
Barkham M, Bewick B, Mullin T, et al. The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Couns Psychother Res. 2013;13:3–13.
doi: 10.1080/14733145.2012.729069
Coates R, Ayers S, de Visser R, Thornton A. Evaluation of the CORE-10 to assess psychological distress in pregnancy. J Reprod Infant Psychol. 2020;38:311–23.
pubmed: 31870174
doi: 10.1080/02646838.2019.1702631
Connell J, Barkham M. CORE-10 User Manual, Version 1.1. CORE system Trust & CORE Information Management Systems Ltd. 2007.
Ekelin M, Svalenius EC, Dykes A. Developing the PEER-U scale to measure parents’ expectations, experiences and reactions to routine ultrasound examinations during pregnancy. J Reprod Infant Psychol. 2008;26:211–28.
doi: 10.1080/02646830701691368
Righetti PL, Dell’Avanzo M, Grigio M, Nicolini U. Maternal/paternal antenatal attachment and fourth-dimensional ultrasound technique: A preliminary report. Br J Psychol. 2005;96:129–37.
pubmed: 15826328
doi: 10.1348/000712604X15518
de Jong-Pleij EAP, Ribbert LSM, Pistorius LR, Tromp E, Mulder EJH, Bilardo CM. Three-dimensional ultrasound and maternal bonding, a third trimester study and a review. Prenat Diagn. 2013;33:81–8.
pubmed: 23169046
doi: 10.1002/pd.4013
Austin PC, Steyerberg EW. The number of subjects per variable required in linear regression analyses. J Clin Epidemiol. 2015;68:627–36.
pubmed: 25704724
doi: 10.1016/j.jclinepi.2014.12.014
Mishra P, Pandey C, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth. 2017;22:67–72.
Alkharusi H. Categorical variables in regression analysis: A comparison of dummy and effect coding. Int J Educ. 2012;4:202.
doi: 10.5296/ije.v4i2.1962
Kleinheksel AJ, Rockich-Winston N, Tawfik H, Wyatt TR. Qualitative research in pharmacy education: Demystifying content analysis. Am J Pharm Educ. 2020;84:127–37.
doi: 10.5688/ajpe7113
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.
pubmed: 16204405
doi: 10.1177/1049732305276687
Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14.
doi: 10.1016/j.npls.2016.01.001
Condon JT. The assessment of antenatal emotional attachment: Development of a questionnaire instrument. Br J Med Psychol. 1993;66:167–83.
pubmed: 8353110
doi: 10.1111/j.2044-8341.1993.tb01739.x
Ustunsoz A, Guvenc G, Akyuz A, Oflaz F. Comparison of maternal-and paternal-fetal attachment in Turkish couples. Midwifery 2010;26. https://doi.org/10.1016/j.midw.2009.12.006 .
Kaur S, Sagar N. Comparative study to assess the maternal and paternal fetal attachment among the expectant mothers and fathers. Int J Reprod Contraception, Obstet Gynecol. 2017;6:3134.
doi: 10.18203/2320-1770.ijrcog20172948
Rowe H, Fisher J, Quinlivan J. Women who are well informed about prenatal genetic screening delay emotional attachment to their fetus. J Psychosom Obstet Gynecol. 2009;30:34–41.
doi: 10.1080/01674820802292130
Rothman B. The tentative pregnancy: Prenatal diagnosis and the future of motherhood. 1st ed. New York: Viking; 1986.
Thomas GM, Roberts J, Griffiths FE. Ultrasound as a technology of reassurance? How pregnant women and health care professionals articulate ultrasound reassurance and its limitations. Sociol Heal Illn. 2017;39:893–907.
doi: 10.1111/1467-9566.12554
Pilnick A, Zayts O. ‘It’s just a likelihood’: Uncertainty as topic and resource in conveying ‘positive’ results in an antenatal screening clinic. Symb Interact. 2014;37:187–208.
doi: 10.1002/symb.99
Harpel TS. Fear of the unknown: Ultrasound and anxiety about fetal health. Health (Irvine Calif). 2008;12:295–312.
Reed K, Kochetkova I, Whitby E. Visualising uncertainty: Examining women’s views on the role of Magnetic Resonance Imaging (MRI) in late pregnancy. Soc Sci Med. 2016;164:19–26.
pubmed: 27451338
doi: 10.1016/j.socscimed.2016.07.012
Close C, Bateson K, Douglas H. Does prenatal attachment increase over pregnancy? Br J Midwifery. 2020;28:436–41.
doi: 10.12968/bjom.2020.28.7.436
van der Zande ISE, van der Graaf R, Hooft L, van Delden JJM. Facilitators and barriers to pregnant women’s participation in research: A systematic review. Women and Birth. 2018;31:350–61.
pubmed: 29373261
doi: 10.1016/j.wombi.2017.12.009
Williams C. Dilemmas in fetal medicine: Premature application of technology or responding to women’s choice? Sociol Heal Illn. 2006;28:1–20.
doi: 10.1111/j.1467-9566.2006.00480.x
Westerneng M, Diepeveen M, Witteveen AB, et al. Experiences of pregnant women with a third trimester routine ultrasound - A qualitative study. BMC Pregnancy Childbirth. 2019;19:1–10.
doi: 10.1186/s12884-019-2470-9
Walsh J. Definitions matter: If maternal-fetal relationships are not attachment, what are they? Arch Womens Ment Health. 2010;13:449–51.
pubmed: 20217158
doi: 10.1007/s00737-010-0152-8
Harwood K, McLean N, Durkin K. First-time mothers’ expectations of parenthood: What happens when optimistic expectations are not matched by later experiences? Dev Psychol. 2007;43:1–12.
pubmed: 17201504
doi: 10.1037/0012-1649.43.1.1
Kowalcek I, Huber G, Mühlhof A, Gembruch U. Prenatal medicine related to stress and depressive reactions of pregnant women and their partners. J Perinat Med. 2003;31:216–24.
pubmed: 12825477
doi: 10.1515/JPM.2003.029
Redshaw J, Henderson M. Fathers’ engagement in pregnancy and childbirth. BMC Pregnancy Childbirth. 2013;13:1–15.
doi: 10.1186/1471-2393-13-70
Thomson G, Balaam MC, Nowland R, Crossland N, Moncrieff G, Heys S, et al. Companionship for women/birthing people using antenatal and intrapartum care in England during COVID-19: A mixed-methods analysis of national and organisational responses and perspectives. BMJ Open. 2022;12:1–12.
doi: 10.1136/bmjopen-2021-051965
Genesoni L, Tallandini MA. Men’s psychological transition to fatherhood: An analysis of the literature, 1989–2008. Birth. 2009;36:305–18.
pubmed: 20002423
doi: 10.1111/j.1523-536X.2009.00358.x
Finnbogadottir H, Svalenius EC, Persson EK. Expectant first-time fathers’ experiences of pregnancy. Midwifery. 2003;19:96–105.
pubmed: 12809629
doi: 10.1016/S0266-6138(03)00003-2
Yogman M, Garfield CF. Fathers’ roles in the care and development of their children: The role of pediatricians. Pediatrics. 2016;138:1–15.
doi: 10.1542/peds.2016-1128
Dolan A, Coe C. Men, masculine identities and childbirth. Sociol Heal Illn. 2011;33:1019–34.
doi: 10.1111/j.1467-9566.2011.01349.x
Alio A. Rationale and strategies for engaging fathers in maternal and infant health programes: A summary of promising practices. 2017 https://gaobgyn.org/gaobgyn/wp-content/uploads/2020/06/Engaging-Fathers-MIH-CB-Blog1.pdf .
Salzmann-Erikson M, Eriksson H. Fathers sharing about early parental support in health-care - virtual discussions on an Internet forum. Heal Soc Care Community. 2013;21:381–90.
doi: 10.1111/hsc.12028
Chin R, Hall P, Daiches A. Fathers’ experiences of their transition to fatherhood: A metasynthesis. J Reprod Infant Psychol. 2011;29:4–18.
doi: 10.1080/02646838.2010.513044
Cuijlits I, van de Wetering AP, Endendijk JJ, van Baar AL, Potharst ES, Pop VJM. Risk and protective factors for pre- and postnatal bonding. Infant Ment Health J. 2019;40:768–85.
pubmed: 31430393
doi: 10.1002/imhj.21811
Widarsson M, Engström G, Tydén T, Lundberg P, Hammar LM. ‘Paddling upstream’: Fathers’ involvement during pregnancy as described by expectant fathers and mothers. J Clin Nurs. 2015;24:1059–68.
pubmed: 25662781
doi: 10.1111/jocn.12784
Masroor I, Ahmed H, Ajmal F. Impact of prenatal ultrasound consultation on maternal anxiety. J Dow Univ Heal Sci. 2008;2:16–20.
Skelton E, Harrison G, Rutherford M, Ayers S, Malamateniou C. UK obstetric sonographers ’ experiences of the COVID-19 pandemic : Burnout, role satisfaction and impact on clinical practice. Ultrasound. 2023;31(1):12–22.
Skelton E, Smith A, Harrison G, Rutherford M, Ayers S, Malamateniou C. “It has been the most difficult time in my career”: A qualitative exploration of UK obstetric sonographers’ experiences during the COVID-19 pandemic. Radiography. 2023;29:582–9.
pubmed: 37004376
doi: 10.1016/j.radi.2023.03.007
Condon JT, Corkindale C. The correlates of antenatal attachment in pregnant women. Br J Med Psychol. 1997;70:359–72.
pubmed: 9429755
doi: 10.1111/j.2044-8341.1997.tb01912.x
Karaca PP, Koyucu RG, Aksu SÇ. The relatıonshıp between pregnant women’s anxıety levels about coronavırus and prenatal attachment. Arch Psychiatr Nurs. 2022;36:78–84.
pubmed: 35094830
doi: 10.1016/j.apnu.2021.12.001
Göbel A, Stuhrmann LY, Harder S, Schulte-Markwort M, Mudra S. The association between maternal-fetal bonding and prenatal anxiety: An explanatory analysis and systematic review. J Affect Disord. 2018;239:313–27.
pubmed: 30031251
doi: 10.1016/j.jad.2018.07.024
van den Bergh B, Simons A. A review of scales to measure the mother-foetus relationship. J Reprod Infant Psychol. 2009;27:114–26.
doi: 10.1080/02646830802007480
Yarcheski A, Mahon NE, Yarcheski TJ, Hanks MM, Cannella BL. A meta-analytic study of predictors of maternal-fetal attachment. Int J Nurs Stud. 2009;46:708–15.
pubmed: 19081091
doi: 10.1016/j.ijnurstu.2008.10.013
Lee MA, Schoppe-Sullivan SJ, Kamp Dush CM. Parenting perfectionism and parental adjustment. Pers Individ Dif. 2012;52:454–7.
pubmed: 22328797
pmcid: 3274380
doi: 10.1016/j.paid.2011.10.047
Masroor I, Ahmed H, Ajmal F. Impact of prenatal ultrasound consultation on maternal anxiety. J Dow Univ Heal Sci. 2008;2:16–20.
Pulliainen H, Niela-Vilén H, Ekholm E, Ahlqvist-Björkroth S. Experiences of interactive ultrasound examination among women at risk of preterm birth: A qualitative study. BMC Pregnancy Childbirth. 2019;19:1–8.
doi: 10.1186/s12884-019-2493-2
Walsh TB. Your baby is so happy, active, uncooperative: How prenatal care providers contribute to parents’ mental representations of the baby. Midwifery. 2020;83:102630.
pubmed: 32006801
doi: 10.1016/j.midw.2020.102630
Kibiswa NK. Directed qualitative content analysis (DQlCA): A tool for conflict analysis. Qual Rep. 2019;24:2059–79.
Krumpal I. Determinants of social desirability bias in sensitive surveys: A literature review. Qual Quant. 2013;47:2025–47.
doi: 10.1007/s11135-011-9640-9
Darwin Z, Galdas P, Hinchliff S, Littlewood E, McMillan D, McGowan L, et al. Fathers’ views and experiences of their own mental health during pregnancy and the first postnatal year: A qualitative interview study of men participating in the UK Born and Bred in Yorkshire (BaBY) cohort. BMC Pregnancy Childbirth. 2017;17:1–15.
doi: 10.1186/s12884-017-1229-4
Panter-Brick C, Burgess A, Eggerman M, McAllister F, Pruett K, Leckman JF. Practitioner review: Engaging fathers - Recommendations for a game change in parenting interventions based on a systematic review of the global evidence. J Child Psychol Psychiatry Allied Discip. 2014;55:1187–212.
doi: 10.1111/jcpp.12280
Thornton J. Clinical trials suspended in UK to prioritise covid-19 studies and free up staff. BMJ. 2020;368:m1172.
pubmed: 32205354
doi: 10.1136/bmj.m1172
Riley RD, Ensor J, Snell KIE, Harrell FE, Martin GP, Reitsma JB, et al. Calculating the sample size required for developing a clinical prediction model. BMJ. 2020;368:1–12.