The adaptive psychological changes of elective induction of labor in breastfeeding women. (January 2017)

• Record Type: Journal Article
• Authors: Zanardo, Vincenzo; Bertin, Martina; Sansone, Laura; Felice, Laura
• Is Part Of: Early human development. Volume 104(2017)
• Page Start: 13
• Page End: 16
• Publication Date: 2017-01
• Subjects: Elective induction of labor -- Breastfeeding -- Edinburg Postnatal Depression Scale -- State and Trait Anxiety Inventory -- Mother to-Infant Bonding Scale; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2016.10.007
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. Methods: We examined the influence of elective labor induction by vaginal prostaglandin at gestational week 41 + 3 days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3 months. Results: One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n = 90) and mothers having received no treatment (unmedicated group, n = 90). The day of discharge mothers completed the Edinburg Postnatal Depression Scale, (EPDS), State and Trait Anxiety Inventory (STAI-Y), and Mother to-Infant Bonding Scale (MIBS). Later they participated in telephone interviews concerning their breastfeeding practices at 1 and 3 months, which were classified according to WHO definitions. When compared with unmedicated, PGE group puerperae scored [median, (IQR)] significantly higher EPDS [9 (7–13) vs 5 (3–8), p 0.003], STAI-state [46 (39–51) vs 39 (34–48), p 0.002], STAI-trait [39 (36–48) vs 34 (32–45), p 0.04], and MIBS [10 (5.25–10) vs 5 (3–4), p 0.002] scores. In addition, while the breastfeeding practices were similar at hospital discharge, at follow-up the labor induced mothers were less likely to maintain full breastfeeding with respect to untreated mothers: 1 month (p 0.001); and 3 months (p 0.003). Conclusion: We present evidence that elective induction of labor by prostaglandins at gestational week 41 + 3 days is associated with reduced exclusive breastfeeding rates at 1 and 3 months after discharge and higher EPDS, STAI, and MIBS scores. Highlights: One reported expression of delivery adaptations is that the breastfeeding of labor induced women is adversely affected. We found worse bonding, anxiety, and depression scores after labor induction by prostaglandin at gestational week 41 + 3 days. Women who vaginally delivered after induction of labor have lower breastfeeding rates at 1 and 3 months postpartum. These data suggest that induction of labor has a heavy psychological load that impair breastfeeding success.