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The Association between Prematurity, Antibiotic Consumption, and Mother-Infant Attachment in the First Year of Life
Marina Fuertes1,2, Anabela Faria3, Joana L Gonçalves4,5
1Centro de Psicologia, University of Porto, 4200-135 Porto, Portugal.
Insights
Mother-infant attachment impacts antibiotic use, but this association differs between full-term and preterm infants. Preterm infants
Area of Science:
- Developmental Psychology
- Neonatal Medicine
- Pharmacology
Background:
- Antibiotic use presents individual and public health challenges.
- Mother-infant attachment quality and maternal sensitivity are linked to antibiotic consumption.
- Ambivalent attachment in infants may correlate with higher antibiotic use.
Purpose of the Study:
- To investigate the association between mother-infant attachment and antibiotic use across different infant gestational ages.
- To determine if the impact of attachment on antibiotic use differs between full-term and preterm infants.
- To explore the influence of infant gestational age and maternal sensitivity on antibiotic prescription patterns.
Main Methods:
- A longitudinal study comparing three groups: full-term, moderate-to-late preterm, and very-to-extreme preterm infants.
- Assessment of infant attachment using the Ainsworth Strange Situation at 12 months corrected age.
- Analysis of antibiotic use in relation to attachment strategies, gestational age, and maternal sensitivity.
Main Results:
- Infant attachment strategy is associated with antibiotic uptake, with variations across samples.
- In full-term infants, ambivalent attachment showed the highest antibiotic use; in very-to-extreme preterm infants, avoidant attachment did.
- Higher infant gestational age and lower maternal sensitivity were linked to increased antibiotic use.
Conclusions:
- The relationship between infant attachment and antibiotic use is complex and context-dependent, varying significantly with prematurity.
- Healthcare vigilance for very preterm infants may mitigate the influence of attachment on antibiotic prescriptions.
- Maternal sensitivity emerges as a crucial factor influencing antibiotic use across different infant populations.
Abstract:
Antibiotics have individual and public-health drawbacks. Nevertheless, mother-infant attachment quality and maternal sensitivity are associated with antibiotic use. Ambivalent-attached infants are more likely to consume antibiotics than other infants. Conceivably, the emotional over-externalization of ambivalent-attached infants and maternal anxiety when infants are ill raise concerns in healthcare professionals, leading to antibiotic over-prescriptions. However, because infants prematurely born, particularly those with less than 32 weeks of gestation, are under more accurate health vigilance, the impact of infant and maternal behavior on antibiotic prescription may vanish in this sample. To test this hypothesis, we performed a longitudinal study to compare antibiotic use and the quality of mother-infant attachment in three groups: 86 infants born at full-term, 44 moderate-to-late preterm infants (32-36 gestation weeks), and 58 very-to-extreme preterm infants (<32 gestation weeks). Infants' attachment was observed with the Ainsworth Strange Situation's experimental paradigm at 12 months of corrected age. Findings indicate that infant attachment strategy is associated with antibiotics uptake, but results vary across samples. The proportion of infants that used antibiotics is highest among ambivalent-attached infants in the full-term sample but highest among avoidant-attached infants in the very-to-extreme premature sample. Moreover, higher infant gestational age and lower maternal sensitivity determine higher antibiotic use.
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