What helps the mother of a preterm infant become securely attached, responsive and well-adjusted?

ObjectiveTo investigate the relationship between the predictor variables of experiential avoidance, relationship satisfaction, prenatal expectations (compared to postnatal experience) and postpartum support, and the criterion variables of maternal attachment, maternal psychological symptoms and maternal responsiveness, after controlling for birth weight.DesignA quantitative survey study.MethodThe participants were 127 mothers of preterm infants (delivery prior to 37 weeks gestation, <24 months corrected age) recruited through parent support organisations. The web-based survey included measures of: demographics, postpartum support and prenatal expectations (compared to postnatal experience)—all designed for this study, as well as maternal attachment, (MPAS) maternal responsiveness (MIRI), experiential avoidance (AAQ), maternal psychological symptoms (DASS-21) and relationship satisfaction (RQI). Three standard multiple regression analyses were conducted.ResultsThe combined effects of experiential avoidance, relationship satisfaction, prenatal expectations (compared to postnatal experience) and postpartum support accounted for a significant 21% of variance in maternal attachment, Fch (4,121) = 8.01, p < .001, a significant 38% of variance in maternal psychological symptoms Fch (4,121) = 18.38, p < .001, and a significant 11% of variance in maternal responsiveness, Fch (4,121) = 3.78, p = .013 after controlling for birth weight.ConclusionThe four predictor variables predicted maternal attachment, psychological symptoms and responsiveness after controlling for birth weight, with experiential avoidance being the most important predictor, followed by prenatal expectations (compared to postnatal experience), relationship satisfaction, then postpartum support. This has implications for designing interventions to optimise attachment and responsiveness, and minimise psychological symptoms, in mothers of infants born preterm.

► Mothers of preterm infants.
► Predicting maternal attachment, psychological symptoms and responsiveness.
► Significant modifiable predictors of maternal problems.
► Implications for designing interventions.