The association between epidural analgesia during labor and mother-infant bonding

Study objective: This study was aimed to assess the association between the use of epidural analgesia during labor and mother-infant bonding. Design: A cross-sectional study. Setting: Maternity ward at Soroka University Medical Center during 2020. Patients: Women who delivered a singleton live-born infant vaginally in their immediate post-partum period. Interventions: Women completed questionnaires. 25 items post-partum bonding questionnaire (PBQ) to assess mother-infant bonding (A high score on the PBQ indicates impaired mother-infant bonding) and the Edinburgh postnatal depression scale (EPDS) questionnaire to assess risk for post-partum depression. Measurements: The study used PBQ questionnaire and four sub-scales to assess mother-infant bonding and the EPDS questionnaire to assess risk for post-partum depression. Generalized linear regression models (gamma) were constructed to examine the association between epidural analgesia and mother-infant bonding total score and impaired bonding sub-scale, while adjusting for confounders Additional information such as pregnancy complications and sociodemographic data was drawn from women's medical records. Main results: A total of 234 women were included in the final analysis, of them 126 (53.8%) delivered with epidural analgesia. The total PBQ score was significantly lower among women who received epidural analgesia compared to women without epidural analgesia (7.6 vs. 10.2, p = 0.024), demonstrating a better mother-infant bonding. Using two multivariable linear regression models, controlling for confounders such as maternal age and educational status, epidural analgesia during labor was independently associated with a better mother-infant bonding total score and better impaired bonding sub-scale score (Beta coefficient -0.252, 95% CI-0.5; -0.006, p = 0.045 and Beta coefficient -0.34, 95% CI-0.52; -0.08, p = 0.01 for mother-infant bonding total score and sub-scale score, respectively). No differences in post-partum depression risks were found between the groups (EDPS >= 13, 5.7% vs. 13%, p = 0.058). Conclusion: Our study demonstrated better mother-infant bonding among women delivering with epidural analgesia.