Caregiving relationships in the postnatal period are critical to an infant\'s development. Preterm infants and their parents face unique challenges in this regard, with infants experiencing separation from parents, uncomfortable procedures, and increased biologic vulnerability, and parents facing difficulties assuming caregiver roles and increased risk for psychological distress. To better understand the NICU parent-infant relationship, we conducted a review of the literature and identified 52 studies comparing observed maternal, infant, and dyadic interaction behavior in preterm dyads with full-term dyads. Eighteen of 40 studies on maternal behavior found less favorable behavior, including decreased sensitivity and more intrusiveness in mothers of preterm infants, seven studies found the opposite, four studies found mixed results, and 11 studies found no differences. Seventeen of 25 studies on infant behavior found less responsiveness in preterm infants, two studies found the opposite, and the remainder found no difference. Eighteen out of 14 studies on dyad-specific behavior reported less synchrony in preterm dyads and the remainder found no differences. We identify confounding factors that may explain variations in results, present an approach to interpret existing data by framing differences in maternal behavior as potentially adaptive in the context of prematurity, and suggest future areas for exploration.
Las relaciones de prestación de cuidados en el período postnatal son críticas para el desarrollo del infante. Los infantes nacidos prematuramente y sus progenitores enfrentan retos únicos a este respecto, con los infantes que experimentan la separación de sus progenitores, procedimientos incómodos, así como un aumento en la vulnerabilidad biológica; y los progenitores enfrentando dificultades al asumir el papel de cuidadores y el aumento de riesgo de angustia sicológica. Para comprender mejor la relación progenitor-infante en la Unidad Neonatal de Cuidados Intensivos (NICU), llevamos a cabo una revisión de la literatura e identificamos 52 estudios que comparan la observada conducta de interacción materna, del infante y de la díada en díadas de infantes prematuros con díadas de infantes de gestación completa. Dieciocho de 40 estudios sobre la conducta materna encontraron una menos favorable conducta, incluyendo una baja en la sensibilidad y más intrusión en el caso de madres de infantes prematuros; 7 estudios encontraron que se daba la situación opuesta; 4 estudios presentaron resultados mixtos; y 11 estudios no encontraron diferencias. Diecisiete de 25 estudios sobre el comportamiento del infante encontraron una menor capacidad de respuesta en infantes prematuros; dos estudios encontraron que se daba la situación opuesta; y el resto de los estudios no encontró ninguna diferencia. Ocho de 14 estudios sobre el comportamiento específico de la díada reportaron menos sincronía en las díadas con infantes prematuros y el resto de los estudios no encontró ninguna diferencia. Identificamos factores confusos que pudieran explicar las variaciones en los resultados, presentamos un acercamiento para interpretar la información existente por medio de enmarcar las diferencias en la conducta materna como potencialmente adaptable en el contexto del nacimiento prematuro, y sugerimos futuras áreas para ser exploradas.
Les relations de soin dans la période postnatale sont critiques pour le développement du nourrisson. Les bébés nés avant terme et leurs parents font face à des défis uniques à cet égard, avec les bébés faisant l\'expérience de la séparation des parents, des procédures désagréables et difficiles, et une vulnérabilité biologique accrue, et les parents faisant face aux difficultés assumant des rôles de soignants et étant à risque plus élevé de détresse psychologique. Afin de comprendre la relation parent-nourrisson USIN nous avons passé en revue toutes les recherches et identifié 52 études comparant le comportement d\'interaction dyadique, maternel et du nourrisson chez des dyades prématurées avec des dyades à plein terme. 18 des 40 études sur le comportement maternel ont trouvé un comportement moins que favorable, y compris une sensibilité décrue et plus d\'intrusion chez les mères de nourrissons prématurés, 7 études ont trouvé le contraire, 4 études ont trouvé des résultats mélangés, et 11 études n\'ont trouvé aucune différence. 17 études sur 25 sur le comportement du nourrisson ont trouvé une réaction moindre chez les nourrissons prématurés deux études ont trouvé le contraire, et le reste n\'a trouvé aucune différence. 8 études sur 14 sur le comportement spécifique à la dyade ont fait état de moins de synchronie chez les dyades avant terme et les autres études n\'ont trouvé aucune différence. Nous identifions des facteurs confondants qui pourraient expliquer des variations dans les résultats et nous présentons une approche pour interpréter les données existantes en cadrant des différences dans le comportement maternel comme étant potentiellement adaptatives dans le contexte de la prématurité et nous suggérons des domaines futurs d\'exploration.
Betreuungsbeziehungen in der postnatalen Phase sind für die Entwicklung eines Säuglings entscheidend. Frühgeborene und ihre Eltern sind in dieser Hinsicht mit besonderen Herausforderungen konfrontiert: Die Säuglinge erleben die Trennung von ihren Eltern, unangenehme Prozeduren und eine erhöhte biologische Anfälligkeit. Die Eltern hingegen haben Schwierigkeiten, die Rolle der Betreuenden einzunehmen, und ein erhöhtes Risiko für psychische Probleme. Um die Eltern-Säuglings-Beziehung auf der Neugeborenen-Intensivstation besser zu verstehen, haben wir Literatur ausgewertet und 52 Studien identifiziert, in denen das beobachtete Mutter-Kind-Interaktionsverhalten bei Frühgeborenen-Dyaden mit dem von Reifgeborenen-Dyaden verglichen wurde. 18 von 40 Studien zum mütterlichen Verhalten ergaben ein ungünstigeres Verhalten der Mütter der Frühgeborenen, einschließlich geringerer Sensibilität und größerer Aufdringlichkeit, 7 Studien ergaben das Gegenteil, 4 Studien zeigten gemischte Ergebnisse und 11 Studien stellten keine Unterschiede fest. 17 von 25 Studien über das Säuglingsverhalten stellten eine geringere Reaktionsfähigkeit bei Frühgeborenen fest, zwei Studien fanden das Gegenteil und in den übrigen wurde kein Unterschied festgestellt. 8 von 14 Studien zum dyadenspezifischen Verhalten berichteten eine geringere Synchronität bei Frühgeborenen-Dyaden, während die übrigen keine Unterschiede feststellten. Wir identifizieren Störfaktoren, die Unterschiede in den Ergebnissen erklären könnten, und stellen einen Ansatz zur Interpretation vorhandener Daten vor, indem wir Unterschiede im mütterlichen Verhalten als potenziell adaptiv im Kontext der Frühgeburtlichkeit betrachten. Außerdem schlagen wir künftige Forschungsbereiche vor.
产后期的护理关系对婴儿的发育至关重要。早产婴儿及其父母在这方面面临着独特的挑战, 婴儿会经历与父母分离、不舒服的治疗过程和生物学脆弱性的增加, 而父母则面临着难以承担看护者角色的困难以及心理困扰的风险增加。为了更好地理解NICU中的母婴关系, 我们进行了文献综述, 并确定了52项研究, 比较了早产婴儿和足月婴儿中观察到的母亲、婴儿和双人互动行为。在40项关于母亲行为的研究中, 有18项发现了不太有利的行为, 包括早产婴儿的母亲表现出较低的敏感性和更多的侵入性, 有7项研究发现相反的结果, 有4项研究发现混合结果, 有11项研究未发现差异。在25项关于婴儿行为的研究中, 有17项发现早产婴儿的反应能力较低, 有2项研究发现相反的结果, 其余研究未发现差异。在14项关于双人特定行为的研究中, 有8项报告称早产母婴组的同步性较低, 其余研究没有发现差异。我们确定了可能解释结果差异的混杂因素, 并提出了一种方法, 通过将母亲行为的差异界定为在早产背景下的潜在适应性来解释现有数据, 我们还提出了未来的研究方向。.
تعد علاقات تقديم الرعاية في فترة ما بعد الولادة ذات أهمية محورية لنمو الرضيع. يواجه الخدج وأولياء أمورهم تحديات فريدة في هذا الصدد، حيث يعاني الرضع من الانفصال عن والديهم، وإجراءات غير مريحة، وزيادة الضعف البيولوجي، ويواجه الآباء صعوبات في تولي أدوار مقدمي الرعاية وزيادة خطر الإصابة بالضيق النفسي. لفهم العلاقة بين الوالدين والرضيع بشكل أفضل، أجرينا مراجعة للأدبيات وحددنا 52 دراسة تقارن سلوك التفاعل بين الأمهات والرضيع وسلوكيات تفاعل ثنائيات الخدج مع ثنائيات كاملة المدة. وجدت 18 من 40 دراسة حول سلوك الأمهات سلوكًا أقل إيجابية، بما في ذلك انخفاض الحساسية والمزيد من التدخل لدى أمهات الخدج، بينما وجدت 7 دراسات عكس ذلك، وتوصلت 4 دراسات إلى نتائج مختلطة، ولم تجد 11 دراسة أي فروق. وجدت 17 من 25 دراسة حول سلوك الرضع استجابة أقل عند الخدج، ووجدت دراستان عكس ذلك، ولم تتوصل بقية الدراسات إلى أي فروق. وتوصلت 8 من أصل 14 دراسة حول السلوك الثنائي المحدد إلى وجود تزامن أقل في الثنائيات الخدج ولم تجد بقية الدراسات أي اختلافات. حددت الدراسة العوامل المتضاربة التي قد تفسر الاختلافات في النتائج، ونقدم منهجاً لتفسير البيانات الموجودة من خلال تأطير الاختلافات في سلوك الأم على أنها قابلة للتكيف في سياق الخداج، ونقترح مجالات مستقبلية للاستكشاف.

BACKGROUND: Maternal perinatal depression has been shown to have long lasting effects on children\'s development. Studies have described the relationship of perinatal depression on children\'s cognition, especially negative effects on intelligence quotient (IQ). However, a recent examination of the current studies to discern the patterns and strength of associations between perinatal depression and child IQ is not available.
OBJECTIVE: The purpose of this systematic review is to discern the effects of perinatal depression, prenatally and within the first 12 months of the postpartum period, on the IQ of the child aged 0-18 years old.
METHODS: We searched the electronic databases: PubMed and CINAHL. We identified 1633 studies, and included 17 studies in the final review based on pre-determined criteria. After the data was extracted, we assessed the strength of the study using the national heart, lung, and blood institute quality assessment tool for observational cohort and cross-sectional studies. This systematic review had a total sample of 10,757 participants.
RESULTS: Across the studies, we identified a relationship between limited maternal responsiveness due to postpartum depression and a decrease in full IQ scores in younger children. Male children were found to be more sensitive to the postpartum depression, resulting in a decrease in IQs, in comparison to female children.
CONCLUSIONS: Policies should be implemented to identify women suffering from perinatal depression to mitigate the effects of the disorder for both the mother and her child.
Maternal perinatal depression has been shown to have far-reaching effects on children’s development. However, a recent examination of the current studies to discern the associations between perinatal depression and child IQ is not available. In this systematic review, we identified a relationship between limited maternal responsiveness due to postpartum depression and a decrease in full IQ scores in younger children. Male children were more sensitive to postpartum depression, resulting in a decrease in IQs, in comparison to female children..

Child development is strongly influenced by maternal characteristics. Maternal sensitivity, as well as risks to and outcomes of sensitive maternal style, are well studied in industrialised western contexts, but it is unclear if this is the case for other contexts. Sub-Saharan Africa has been subjected to and continues to negotiate socio-economic and psychological sequelae of colonial and race-based politics: exploring the nature and outcomes of early caregiver input in such challenging conditions is imperative. This scoping review thus aims to 1) evaluate the nature and extent of quantified observational assessments of dyadic interactions, with a focus on maternal sensitivity, in Sub-Saharan Africa and 2) ascertain which risk and outcome factors have been examined in relation to maternal sensitivity. Study quality and cross-cultural appropriateness will also be considered. The search using expanded search terms yielded 20 papers -four characterizing maternal sensitivity or style, eight examining maternal sensitivity in relation to risks and outcomes, and eight intervention studies examining efforts to improve maternal sensitivity. Most research was conducted in South Africa - only seven studies were conducted in four other countries. Researchers used a wide array of coding schemes, mostly developed in the west. Ten studies made some adaptations to measures. Language issues and cultural considerations were often not explicitly addressed. Taken together, very limited research on this important topic exists. For the work that does exist, questions around westernized assumptions, language, and appropriateness of measures remain. Substantially more research, informed by both culturally flexible conceptualizations and methodological rigour, is required.

The current systematic review examines whether there is an association between the genetic 5-HTTPLR polymorphism and parenting, and the mechanisms by which this association operates. The literature was searched in various databases such as PubMed, Scopus, and ScienceDirect. In line with our inclusion criteria, nine articles were eligible out of 22. Most of the studies analysed in this review found an association between 5HTTLPR and parenting. Four studies found a direct association between 5-HTTLPR and parenting with conflicting findings: two studies found that mothers carrying the short variant were more sensitive to their infants, while two studies found that parents carrying the S allele were less sensitive. In addition, several studies found strong interaction between genetic and environmental factors, such as childhood stress and disruptive child behaviour, quality of early care experiences, poor parenting environment, and quality of the environment. Only one study found an association between children\'s 5HTTLPR and parenting. Parenting can be described as a highly complex construct influenced by multiple factors, including the environment, as well as parent and child characteristics. According to the studies, maternal 5-HTTLPR polymorphism is most likely to be associated with sensitive parenting.

Introduction: Breastfeeding has been associated to an improved mother-child bond, although this link is lacking the sufficient empirical support. Aims: The aims of this study were to carry out a systematic review as a continuation to the one by Jansen et al., and to clarify the link between breastfeeding and mother-infant relationships. Materials and Methods: Data sources: A search was conducted using PsycINFO, MEDLINE, and CINAHL (2008-2018), using both free text words and subject headings. Additional hand-searching was performed. Study selection: The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) framework guided (the reporting of) the study selection and data extraction. Eligible articles were subsequently selected by title, abstract, and full text review. Data extraction: Data regarding study setting, participants, breastfeeding, mother-infant relationships, and outcome measures were extracted in a systematic way. Results of Data Synthesis: Ultimately, 13 articles were included. Most studies were conducted in Europe (46.15%) and were nonexperimental studies (92.3%). Eight studies were longitudinal, using between two and five assessment time points. The instruments used to assess the bond between mother and child showed great variability. From the studies, 8 (61.5%) employed self-report measures and four assessed maternal perception. Others used open-ended questions regarding the maternal lactation process or about the mother\'s activity while breastfeeding. Other measures used were maternal perception of her baby and personality variables associated to breastfeeding. Five articles studied the bond using external observations of the interactions between mother-child. The quality of the studies (Medical Education Research Studies Quality Instrument [MERSQI]) was overall fair to good. Conclusion: It is complicated to extract generalizable results because of the conceptual and instrumental variability of the mother-child relationship. This association is complex and the way in which breastfeeding is carried out would appear to be a decisive factor, influenced in turn by additional variables that should also be taken into account. The relationship indicators most frequently associated to breastfeeding are maternal sensitivity and secure attachment.

Functional magnetic resonance imaging (fMRI) has increasingly been employed to establish whether there is a specific brain neural network dedicated to maternal responsiveness. We undertook systematic review and meta-analysis of all studies in which healthy new mothers were exposed to visual stimuli of own versus other infants to determine the quality of evidence for a dedicated maternal neural network. Systematic literature review revealed a pattern of specific neural responses commonly induced by visual infant paradigms. Brain areas consistently reported as activated in mothers in response to own versus unknown infant included the left thalamus, bilateral pre-central gyrus, left limbic lobe, uncus, amygdala and left caudate. These regions are implicated in reward, attention, emotion processing and other core social cognitive skills. Meta-analysis, however, revealed a more limited subset of brain areas activated in mothers specifically in response to their own versus unknown infant and suggested considerable inter-study variability. Further work is needed if functional imaging is to become an objective tool for the assessment of neural pathways associated with distinct patterns of maternal care behaviour. Such a tool would be invaluable in developing biomarkers of neural activity associated with healthy maternal care and for monitoring treatment/intervention effects of costly parenting interventions.

Early secure maternal-child attachment relationships lay the foundation for children\'s healthy social and mental development. Interventions targeting maternal sensitivity and maternal reflective function during the first year of infant life may be the key to promoting secure attachment. We conducted a narrative systematic review and meta-analysis to examine the effectiveness of interventions aimed at promoting maternal sensitivity and reflective function on maternal-child attachment security, as measured by the gold standard Strange Situation (M. Ainsworth, M. Blehar, B. Waters, & S. Wall, 1978) and Q-set (E. Waters & K. Deane, 1985). Studies were identified from electronic database searches and included randomized or quasi-randomized controlled parallel-group designs. Participants were mothers and their infants who were followed up to 36 months\' postpartum. Ten trials, involving 1,628 mother-infant pairs, were included. Examination of the trials that provided sufficient data for combination in meta-analysis revealed that interventions of both types increased the odds of secure maternal-child attachment, as compared with no intervention or standard intervention (n = 7 trials; odds ratio: 2.77; 95% confidence interval: 1.69, 4.53, n = 965). Of the three trials not included in the meta-analyses, two improved the likelihood of secure attachment. We conclude that interventions aimed at improving maternal sensitivity alone or in combination with maternal reflection, implemented in the first year of infants\' lives, are effective in promoting secure maternal-child attachments. Intervention aimed at the highest risk families produced the most beneficial effects.