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Effect of Mother/Infant Skin-to-Skin Contact on Postpartum Depressive Symptoms and Maternal Physiological Stress

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Sample

N: 90
Subject Ages: Mean maternal age was 29.4 years
Location: Canada, perinatal clinics at two hospitals in a rural eastern area
SES: Not available
Eligibility: Mothers of full-term infants who had no medical problems, and the mothers who had no immediate postpartum complications
Additional:
- 42% with university degree, 39% had some university or postsecondary education, 16% had a high school diploma with no further education, 3% were without a high school diploma
- 99% white/non-Hispanic
- 49% first child, 29% had a previous child, 22% had two or more previous children
- 77% of the mothers chose to initially breastfeed their infant

Hypotheses

Mothers who engaged in skin-to-skin contact with their infants would have fewer depressive symptoms and have lower salivary cortisol than mothers who did not engage in skin-to-skin contact.

Variables Measured, Instruments Used

Depression -
- the Edinburgh Postnatal Depression Scale
- the Center for Epidemiological Studies Depression Scale
Salivary cortisol - samples taken at infant age of 1 week and 1 month

Design—Longitudinal

Findings

Mother/infant skin-to-skin contact lessened the mother’s self-reported depressive symptoms and physiological stress in the first postpartum weeks.
At the one-week visit, the mothers in the skin-to-skin contact group scored significantly lower on the depression scales than the control group. This trend continued at the one-month visit, but the difference was smaller.
By the two- and three-month visits, there were no differences in the two groups' scores on the depression scales.
Mothers in the skin-to-skin contact and control groups did not differ from one another in their salivary cortisol level at either of the test intervals.
Individually, the mothers in the skin-to-skin contact group saw a significant reduction in their own salivary cortisol levels between the one-week and one-month tests, indicating that skin-to-skin contact significantly reduced physiological stress in the mothers.

Limitations

Mothers were not randomized into control or skin-to-skin groups. Mothers were assigned to groups based on the hospital they delivered in.
Study participants were self-selected, choosing whether or not to participate in the study at the time of their children’s births.
There were more mothers in the control group than the skin-to-skin group, and there was a greater number of mothers in the skin-to-skin group that did not meet the criteria for inclusion in the skin-to-skin group.
Mothers in the study were from a homogeneous rural community. This limits the ability to generalize these results to more diverse or high-risk populations.
There was a difference in maternal age between the control group and the skin-to-skin contact group.
Skin-to-skin contact was based on mother’s report.
No test of bidirectional influences in the dyad

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