Comparison of Maternal Infant Attachment in Cesarean Delivery Based on Robson Classification: A Cross Sectional Study

Zohreh Rookesh, Maasume Kaviani, Mahnaz Zarshenas, Marzieh Akbarzadeh

Abstract


Background: The Robson criteria allows for standardized comparisons of data and possible driving changes in Cesarean Section (C/S) rates and complications. The aimed to compare maternal‑infant attachment in C/S based on Robson Classification.

Materials and Methods: This cross‑sectional prospective study was conducted on 369 women who had undergone C/S in Hazrate Zeinab Peace Be Upon Him (PBUH), Hafez, and Shooshtari hospitals affiliated to Shiraz University of Medical Sciences, Iran from April 2018 to March 2019. The study data were collected using a demographic form, an obstetric form, and Avant Checklist (AC) at postpartum and pre‑discharge stages. Each participant was placed in Robson classification and the attachment score was calculated in each Robson Classification, and a comparison was made among the 10 groups. The data were analyzed into the SPSS 16 software and using descriptive statistics and paired t test.

Results: The total mean (SD) score of attachment was 38.73 (18.65) at 1–7 h postpartum and 90.52 (23.79) at pre‑discharge. The highest total mean (SD) score of attachment was observed in group 6 (86.78 (8.70) at postpartum and 118.67 (4.47) at pre‑discharge). The lowest total mean (SD) score of attachment was observed in group 10 (12.79 (2.37) at 1–7 h postpartum and 45.44 (7.99) at pre‑discharge).

Conclusions: Obstetric characteristics in Robson Classification, parity, previous C/S, gestational age, onset of labor, fetal presentation, and number of fetuses were effective in clarifying information. The use of this system is necessary to determine the causes of increased C/S cases in low‑income and middle‑income countries.



Keywords


Attachment, cesarean section, classification, delivery, infant

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References


Vogel JP, Betrán AP, Vindevoghel N, Souza JP, Torloni MR, Zhang J, et al. Use of the Robson classification to assess caesarean section trends in 21 countries: A secondary analysis of two WHO multicountry surveys. Lancet Glob Health 2015;3:e260 70.

Rafiei M, Saei Ghare M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta analysis. Int J Reprod Biomed (Yazd) 2018;16:221 34.

Hehir MP, Ananth CV, Siddiq Z, Flood K, Friedman AM, D’Alton ME. Cesarean delivery in the United States 2005 through 2014: A population based analysis using the Robson 10 Group Classification System. Am J Obstet Gynecol 2018;219:105.e1 11.

Bolognani CV, Reis LBdSM, Dias A, Calderon IdMP. Robson 10 groups classification system to access C section in two public hospitals of the Federal District/Brazil. PLoS One 2018;13:e0192997.

Rooeintan F, Borzabad PA, Yazdanpanah A. The impact of healthcare reform plan on the rate of vaginal delivery and cesarean section in Shiraz (Iran) in 2015. Electron Physician 2016;8:3076 80.

Omani Samani R, Mohammadi M, Almasi Hashiani A, Maroufizadeh S. Cesarean section and socioeconomic status in Tehran, Iran. J Res Health Sci 2017;17:e00394.

Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, et al. Classifications for cesarean section: A systematic review. PLoS One 2011;6:e14566.

Kazmi T, Sarva Saiseema V, Khan S. Analysis of cesarean section rate according to Robson’s 10 group classification. Oman Med J 2012;27:415 7.

Kelly S, Sprague A, Fell DB, Murphy P, Aelicks N, Guo Y, et al. Examining caesarean section rates in Canada using the Robson classification system. J Obstet Gynaecol Canada 2013;35:206 14.

Costa ML, Cecatti JG, Souza JP, Milanez HM, Gülmezoglu MA. Using a caesarean section classification system based on characteristics of the population as a way of monitoring obstetric practice. Reproductive Health 2010;7:13.

Robson MS. Classification of caesarean sections. Fetal Matern Med Rev 2001;12:23 39.

Betran AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: What works, doesn’t work and how to improve it. PLoS One 2014;9:e97769.

Boyd MM. Implementing skin to skin contact for cesarean birth. AORN J 2017;105:579 92.

Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin to skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012;5:CD003519.

Bowlby J. Attachment and Loss, Vol. I: Attachment. London: Hogarth. New York: Basic Books; 1969.

Akbarzadeh M, Moattari M, Abootalebi M. Effect of the basnef model on maternal fetal attachment in the pregnant women referring to the prenatal clinics affiliated to shiraz university of medical sciences. Iran J Neonatol 2017;8:31 7.

Farrant BM, Maybery MT, Fletcher J. Maternal attachment status, mother child emotion talk, emotion understanding, and child conduct problems. Child Dev Res 2013;2013. doi: 10.1155/2013/680428.

Akbarzadeh M, Dokuhaki A, Joker A, Pishva N, Zare N. Teaching attachment behaviors to pregnant women: A randomized controlled trial of effects on infant mental health from birth to the age of three months. Ann Saudi Med 2016;36:175 83.

Dokuhaki A, Akbarzadeh M, Pishava N, Zare N. A study of the effect of training pregnant women about attachment skills on infants’ motor development indices at birth to four months. Family Medicine & Primary Care Review. 2017;19:114 22.

Klaus M, Kennell J, Louis ST. Maternal Infant Bonding: The Impact of Early Separation or Loss on Family Development; Mosby Co; 1976:62.

Giustardi A, Stablum M, De Martino A. Mother infant relationship and bonding myths and facts. J Matern Fetal Neonatal Med 2011;24(Suppl 1):59 60.

Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin to skin contact after a C aesarean section: A review of the literature. Matern Child Nutr 2014;10:456 73.

Lai Y L, Hung C H, Stocker J, Chan T F, Liu Y. Postpartum fatigue, baby care activities, and maternal–infant attachment of vaginal and cesarean births following rooming in. Appl Nurs Res 2015;28:116 20.

The SEA ORCHID Study Group, Laopaiboon M, Lumbiganon P, McDonald SJ, Henderson Smart DJ, Green S, et al. Use of evidence based practices in pregnancy and childbirth: South East Asia optimising reproductive and child health in developing countries project. PLoS One 2008;3:e2646.

Festin MR, Laopaiboon M, Pattanittum P, Ewens MR, Henderson Smart DJ, Crowther CA. Caesarean section in four South East Asian countries: reasons for, rates, associated care practices and health outcomes. BMC Pregnancy Childbirth. 2009;9:17. Published 2009 May 9. doi:10.1186/1471 2393 9 17.

Rajabi A, Maharlouei N, Rezaianzadeh A, Rajaeefard A, Gholami A. Risk factors for C section delivery and population attributable risk for C section risk factors in Southwest of Iran: A prospective cohort study. Med J Islam Repub Iran 2015;29:294.

Kok N, Ruiter L, Hof M, Ravelli A, Mol BW, Pajkrt E, et al. Risk of maternal and neonatal complications in subsequent pregnancy after planned caesarean section in a first birth, compared with emergency caesarean section: A nationwide comparative cohort study. BJOG 2014;121:216 23.

Benedetto C, Marozio L, Prandi G, Roccia A, Blefari S, Fabris C. Short term maternal and neonatal outcomes by mode of delivery. A case controlled study. Eur J Obstet Gynecol Reprod Biol 2007;135:35 40.

Dadipour S, Madani AH, Alvai A, Rozbeh N, Safari Moradabadi A. Survey of the growing trend of cesarean section in Iran and the world. Iran J Obstet Gynecol Infertil 2016;19:8 17.

Khoramrody R. [The Effect of Mothers Touch on Maternal Fetal Attachment]. Tehran: Iran University of Medical Sciences; 2000. p. 30 45.

Setodeh S, Sharif F, Akbarzadeh M. The impact of paternal attachment training skills on the extent of maternal neonatal attachment in primiparous women: a clinical trial. Family Medicine & Primary Care Review. 2018;20(1):47 54. doi:10.5114/fmpcr.2018.73703.

Ghodrati F, Setodeh S, Akbarzadeh M. A study of the effect of domestic violence on maternal neonatal attachment in prim gravida women referred to hospitals affiliated to Shiraz University of Medical Sciences. Biomed Res 2017;28:3794 7.

Moradi Z, Akbarzadeh M, Moradi P, Toosi M, Hadianfard MH. The effect of acupressure at GB 21 and SP 6 acupoints on anxiety level and maternal fetal attachment in primiparous women: A randomized controlled clinical trial. Nurs Midwifery Stud 2014;3:e19948.

Toosi M, Akbarzadeh M, Zare N, Sharif F. Effect of attachment training on anxiety and attachment behaviors of first time mothers. Hayat 2011;17:69 79.

Toosi M, Akbarzadeh M, Ghaemi Z. The effect of relaxation on mother’s anxiety and maternale fetal attachment in primiparous IVF mothers. J Natl Med Assoc 2017;109:164 71.

Gathwala G, Narayanan I. Influence of cesarean section on mother baby interaction. Indian Pediatr 1991;28:45 50.

Schneider LW, Crenshaw JT, Gilder RE. Influence of immediate skin to skin contact during cesarean surgery on rate of transfer of newborns to NICU for observation. Nurs Womens Health 2017;21:28 33.

Curry MA. Maternal attachment behavior mothers self concept the effect of skin to skin contact. Nurs Res 1982;31:73 8.

Messmer PR, Rodriguez S, Adams J, Well Gentry J, Washburn K, Zabaleta I, et al. Effect of kangaroo care on sleep time for neonates. Pediatric nursing. 1997: 23(4):408 414.

Adeli M, Aradmehr M. A comparative study of maternal neonate abdominal and kangaroo (skin to skin) skin contact immediately after birth on maternal attachment behaviors up to 2 months. J Educ Health Promot 2018;7:42.

Ahn HY, Lee J, Shin H J. Kangaroo care on premature infant growth and maternal attachment and post partum depression in South Korea. J Trop Pediatr 2010;56:342 4.

Eslaminia T, Kaviani M, Akbarzadeh M. The effect of skin contact on maternal infant attachment behaviors in emotional, proximity seeking, and caretaking dimensions in planned and unplanned pregnancies in 2017, Iran: A research. Current Women`s Health Reviews 2020;16:1 8. https://doi.org/10.2174/15734048166 66200219102513.

Bin YS, Ford JB, Nicholl MC, Roberts CL. Long term childhood outcomes of breech presentation by intended mode of delivery: A population record linkage study. Acta Obstet Gynecol Scand 2017;96:342 51.

Högberg U, Claeson C, Krebs L, Svanberg AS, Kidanto H. Breech delivery at a University Hospital in Tanzania. BMC Pregnancy Childbirth 2016;16:342.

Macharey G, Gissler M, Ulander V M, Rahkonen L, Väisänen Tommiska M, Nuutila M, et al. Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: A retrospective population based case control study. BMC Pregnancy Childbirth 2017;17:93.

Buist A, Morse CA, Durkin S. Men’s adjustment to fatherhood: Implications for obstetric health care. J Obstet Gynecol Neonatal Nurs 2003;32:172 80.

Evans T, Whittingham K, Boyd R. What helps the mother of a preterm infant become securely attached, responsive and well adjusted? Infant Behav Dev 2012;35:1 11.

Wolke D, Eryigit Madzwamuse S, Gutbrod T. Very preterm/ very low birthweight infants’ attachment: Infant and maternal characteristics. Arch Dis Child Fetal Neonatal Ed 2014;99:F70 5.

Staneva A, Bogossian F, Pritchard M, Wittkowski A. The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review. Women Birth 2015;28:179 93.

Voegtline KM, Stifter CA, Investigators FLP. Late preterm birth, maternal symptomatology, and infant negativity. Infant Behav Dev 2010;33:545 54.

Pichler Stachl E, Pichler G, Baik N, Urlesberger B, Alexander A, Urlesberger P, et al. Maternal stress after preterm birth: Impact of length of antepartum hospital stay. Women Birth 2016;29:e105 9.

Surkan PJ, Patel SA, Rahman A. Preventing infant and child morbidity and mortality due to maternal depression. Best Pract Res Clin Obstet Gynaecol 2016;36:156 68.

Beck CT, Driscoll J. Postpartum Mood and Anxiety Disorders: A clinician’s Guide. Jones and Bartlett Learning; 2006.

Smith J, Plaat F, Fisk NM. The natural caesarean: A woman centred technique. BJOG 2008;115:1037 42.

Quarini C, Pearson RM, Stein A, Ramchandani PG, Lewis G, Evans J. Are female children more vulnerable to the long term effects of maternal depression during pregnancy? J Affect Disord 2016;189:329 35.


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