Labor Epidural Analgesia and Mother-Infant Bonding After Vaginal Delivery

Официальное название

Association Between Postpartum Recovery Quality Measured by ObsQoR-10 and Mother-Infant Bonding After Vaginal Delivery: The Role of Labor Epidural Analgesia

Обзор

This prospective observational cohort study aims to evaluate the association between postpartum recovery quality and mother-infant bonding in women undergoing vaginal delivery. Postpartum recovery quality will be assessed using the Obstetric Quality of Recovery-10 (ObsQoR-10) questionnaire, and mother-infant bonding will be evaluated using the Postpartum Bonding Questionnaire (PBQ). Participants will be grouped according to routine clinical labor analgesia preference: women receiving labor epidural analgesia and women not receiving epidural analgesia. Additional assessments will include postpartum pain intensity, anxiety, depressive symptoms, and birth satisfaction. Baseline psychological assessments will be performed before delivery. The primary postpartum evaluation will be conducted between 6 and 24 hours after delivery. Exploratory follow-up assessments will be performed by telephone during postpartum week 2. The study aims to better understand the relationship between labor analgesia, postpartum recovery, and early mother-infant bonding outcomes after vaginal delivery.

Подробное описание

This single-center prospective observational cohort study will be conducted at Atatürk University Research Hospital. The study will include term pregnant women planning vaginal delivery.

Participants will be classified into two cohorts according to routine clinical labor analgesia preference:

Women receiving labor epidural analgesia Women not receiving labor epidural analgesia No experimental intervention will be applied as part of the study protocol. Epidural analgesia, when used, will be administered according to routine clinical practice.

Primary Objective:

To evaluate the association between postpartum recovery quality measured using the ObsQoR-10 questionnaire and mother-infant bonding measured using the Postpartum Bonding Questionnaire (PBQ), and to investigate the role of labor epidural analgesia in this relationship.

Secondary Objectives:

To compare postpartum recovery quality between cohorts To compare mother-infant bonding outcomes between cohorts To evaluate postpartum pain, anxiety, depressive symptoms, and birth satisfaction To assess the association between obstetric variables and postpartum recovery outcomes

Assessments:

Prepartum:

STAIS-5 EPDS

Early postpartum period (6-24 hours):

ObsQoR-10 PBQ STAIS-5 EPDS Pain score (VAS/NRS) Birth satisfaction Likert scale

Postpartum week 2:

PBQ EPDS Participants will provide written informed consent before enrollment. All collected data will be anonymized and analyzed confidentially.

Вмешательства

• Процедура Labor Epidural Analgesia
  Epidural analgesia administered during labor as part of routine clinical care for pain management during vaginal delivery.

Первичные конечные точки

• Mother-Infant Bonding Score [Срок оценки: 6 to 24 hours after vaginal delivery]

Вторичные конечные точки (7)

• Postpartum Recovery Quality Score [Срок оценки: 6 to 24 hours after vaginal delivery]
• Postpartum Pain Intensity [Срок оценки: 6 to 24 hours after vaginal delivery]
• Postpartum Anxiety Level [Срок оценки: 6 to 24 hours after vaginal delivery]
• Postpartum Depressive Symptoms [Срок оценки: 6 to 24 hours after vaginal delivery]
• Birth Satisfaction Score [Срок оценки: 6 to 24 hours after vaginal delivery]
• Mother-Infant Bonding at Postpartum Week 2 [Срок оценки: 2 weeks after vaginal delivery]
• Postpartum Depressive Symptoms at Week 2 [Срок оценки: 2 weeks after vaginal delivery]

Критерии участия

Критерии включения

• Female participants aged 18 to 40 years
• Term singleton pregnancy (≥37 weeks)
• Planned vaginal delivery
• ASA physical status II
• Ability to understand Turkish
• Written informed consent

Критерии исключения

• Contraindications to epidural analgesia including coagulopathy, anticoagulant use, infection, or increased intracranial pressure
• Cesarean delivery
• High-risk pregnancy
• Neonatal intensive care unit requirement
• Major depressive disorder
• Anxiety disorder
• Current psychotropic medication use

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Turkey (Türkiye) · 1 центр

• Ataturk University — Erzurum

Публикации

• Doner S, Efe YS, Elmali F. Turkish adaptation of the state-trait anxiety inventory short version (STAIS-5, STAIT-5). Int J Nurs Pract. 2024 Dec;30(6):e13304. doi: 10.1111/ijn.13304. Epub 2024 Sep 25. PMID 39323115
• Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150:782-6. doi: 10.1192/bjp.150.6.782. PMID 3651732
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• Brockington IF, Oates J, George S, et al. A screening questionnaire for mother-infant bonding disorders. Archives of Women's Mental Health. 2001;3(4):133-140. doi:10.1007/s007370170010
• Dissiz M, Bayri Bingol F, Demirgoz Bal M, Karacam Yilmaz ZD, Karakoc A, Bilgin Z. The Turkish version of the Postpartum Bonding Questionnaire (PBQ): Examination of the validity and reliability and scale structure. J Pediatr Nurs. 2024 Jul-Aug;77:131-139. doi: 10.1016/j.pedn.2024.03.012. Epub 2024 Mar 21. PMID 38518689
• Bell AF, Andersson E. The birth experience and women's postnatal depression: A systematic review. Midwifery. 2016 Aug;39:112-23. doi: 10.1016/j.midw.2016.04.014. Epub 2016 May 7. PMID 27321728
• Waldenstrom U. Women's memory of childbirth at two months and one year after the birth. Birth. 2003 Dec;30(4):248-54. doi: 10.1046/j.1523-536x.2003.00254.x. PMID 14992155
• Hodnett ED. Pain and women's satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002 May;186(5 Suppl Nature):S160-72. doi: 10.1067/mob.2002.121141. PMID 12011880

Идентификаторы

NCT: NCT07582289 · B.30.2.ATA.0.01.00/234 · 2026/2

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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