(222) Associations Between Infant Sleep and Postpartum Maternal-Infant Bonding Among Mothers with Opioid Use Disorder

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: The peripartum period is critical for maternal-infant attachment, laying a foundation for later development of the child. Sleep problems are common in early infancy and broader research has demonstrated that infant sleep difficulties negatively impact maternal-infant bonding. Although opioid-exposed neonates are reported to have more sleep problems, studies have yet to examine the effect of infant sleep on maternal bonding among families with opioid use disorder (OUD). Bonding is particularly important for this population as opioid use during pregnancy is associated with reduced maternal behaviors. We aimed to measure the association between infant sleep and maternal-infant bonding among people with OUD.

Study Design: Using a survey co-designed by individuals with lived experience of OUD during the perinatal period, we enrolled 100 participants between 6 months and 2 years postpartum who had received medications for OUD (methadone, buprenorphine) during their pregnancy. The survey included questions regarding maternal-infant characteristics and postpartum experiences. Participants also completed the Postpartum Bonding Questionnaire (PBQ), on which higher scores indicate impaired maternal-infant bonding. Unadjusted and adjusted linear regression models were used to examine the association between infant sleep and total PBQ score.

Results: Out of 100 study participants, 91 completed the PBQ. Of this, 57% reported that their baby’s sleep was a problem at some point during the first 6 months postpartum. Those who reported infant sleep problems scored 10.40 points higher on the PBQ (95% CI, 5.83–14.96) than participants who did not report sleep problems. The effect of sleep on PBQ remained after stepwise linear regressions of adjusting for maternal-infant characteristics (β 8.95, 95% CI, 3.93–13.97) (see Table 1).

Conclusion: In this pilot study among postpartum individuals with OUD, those who reported difficult infant sleep had more impaired bonding, even after adjusting for several factors of interest. Improving infant sleep may yield increased maternal-infant bonding in families with OUD.

Primary & Presenting Author(s)

Joyce H. Xu, BA
Medical Student
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
Cincinnati, Ohio, United States

Coauthor(s)

SM
Stephanie Merhar, MD, MS
Division of Neonatology and Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Cincinnati, Ohio, United States
Emily A. DeFranco, DO, MS
Professor
University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
JM
Jennifer McAllister, MD
Division of Neonatology and Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Cincinnati, Ohio, United States
Nichole Nidey, PhD
Assistant Professor
Cincinnati Children's Hospital
Cincinnati, Ohio, United States