The association between epidural analgesia during labor and mother-infant bonding

J Clin Anesth. 2022 Sep:80:110795. doi: 10.1016/j.jclinane.2022.110795. Epub 2022 Apr 27.

Abstract

Study objective: This study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding.

Design: A cross-sectional study.

Setting: Maternity ward at Soroka University Medical Center during 2020.

Patients: Women who delivered a singleton live-born infant vaginally in their immediate post-partum period.

Interventions: Women completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression.

Measurements: The study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post- partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub- scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records.

Main results: A total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother -infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother -infant bonding total score and better impaired bonding sub-scale score (Beta coefficient-0.252, 95% CI -0.5; -0.006, p = 0.045 and Beta coefficient - 0.34, 95% CI -0.52; -0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS≥13, 5.7% vs. 13%, p = 0.058).

Conclusion: Our study demonstrated better mother -infant bonding among women delivering with epidural analgesia.

Keywords: Epidural analgesia; Impaired bondibg; Mother -infant bonding; Post-partum depression.

MeSH terms

  • Analgesia, Epidural* / adverse effects
  • Cross-Sectional Studies
  • Depression, Postpartum*
  • Female
  • Humans
  • Infant
  • Mothers
  • Object Attachment
  • Pregnancy