Early relationship between very preterm infant and mother: The role of infant, maternal and dyadic factors

(abstract of the doctoral dissertation)

link to the doctoral dissertation


The primary purpose was to assess the quality and the organization of mother–infant relationship in Finnish firstborn singleton preterm infants and their mothers. In addition, the aim was to study modifying factors such as infant crying, caregiver holding and maternal depression in relation to the mother–preterm infant relationship.


The study groups included 32 (Study I-II) and 38 (Study III-IV) preterm infants (< 1501 g or < 32 weeks) and 46 full term infants. The mother–infant interaction was assessed using PCERA at 6 and 12 months of corrected age.


Maternal representations were studied using WMCI at 12 months of infant’s corrected age. Baby Day Diary was used to explore the infant’s crying and the caregiver’s holding behaviors at 5 months of corrected age. Maternal depression was evaluated using EPDS at 6 months of infant’s corrected age.


This study showed no differences in the maternal attachment classifications, or maternal or dyadic interaction between groups of preterm and full term infants. However, preterm infants demonstrated more sober and withdrawn mood and lower quality in the play and attention skills than full term infants in the interaction situation at 12 months. This study also showed that prolonged crying and maternal depression are negatively related to the mother–infant interaction in the preterm group. Interestingly, the frequent but soothable infant’s crying was positively related to the duration of holding and the duration of holding was positively related to the quality of mother–infant interaction only in the preterm group.

The results of the present study suggest that preterm birth does not, in and of itself, form a risk for maternal attachment or for maternal or dyadic interaction, but together with other risk factors preterm birth may negatively influence the mother–infant relationship. The results also suggests that mothers and their preterm infants develop a different kind of interaction style where the infant’s crying may be a trigger for holding and thus for positive, mutual and reciprocal interaction. This may be an adaptive mechanism protecting the mother–preterm infant relationship.