Monochorionic Twins and the Early Mother-Infant Relationship: An Exploratory Observational Study of Mother-Infant Interaction in the Post-Partum Period

Abstract

The extraordinary increase in twin rates and specifically monochorionic twin pregnancies represents a major public health issue due to the associated increased risks for the mother, the child and their relationship. The aim of the present study was to examine the quality of mothers’ behaviour during mother–infant interaction in the early postpartum period by comparing mothers of twins and mothers of singletons during face-to-face interaction with their infants. Demographic and clinical information was collected by trained research psychologists from the mothers’ and the childrens’ clinical records and from interviews with the mothers. At three months (corrected for prematurity), the interactions of the dyads (11 mother-twin infant dyads and 11 mother-singleton dyads) were filmed at participants’ homes in accordance with the procedure of the Global Rating Scales. Maternal behaviour during interactions was assessed and rated by two trained research psychologists. With regard to the mothers’ interaction with each twin, no differences were found between mothers’ scores in every GRS subscale, indicating that mothers did not interact differently with their twins. Comparisons between mothers of MC twins and mothers of singletons showed that the quality of maternal sensitive behaviour during the interactions were lower in mothers of twins (0.35) Mothers of twins were also more distant during interactions with their babies and more likely to experience depression symptoms than mothers of singletons (0.05). Future research should examine mother-infant relationships following twin birth with larger samples. Such research will be especially useful in evaluating the potential benefits of interventions to promote positive mother-infant interactions.

Ecological momentary assessment of postpartum outcomes in mothers of multiples: lower maternal-infant bonding, higher stress, and more disrupted sleep

“…Bonding is also linked with maternal mental health (Tichelman et al 2019 ) and stress (Lutkiewicz et al 2020 ). Prior work has found that mothers of twins often express sadness and guilt over insufficient time to bond with both babies (Wenze et al 2020 ), and behavioral observation suggests that, compared to mothers of singletons, mothers of twins demonstrate lower sensitivity and more distant behaviors when interacting with their babies (Ionio et al 2022 ). No research of which we are aware has directly measured self-reported maternal-infant bonding in mothers of multiples versus mothers of singletons.…”

Two babies, two bonds: Frequency and correlates of differential maternal‐infant bonding in mothers of twins

“…Thus, one might assume that mothers of dizygotic twins are more likely to report differential maternal-infant bonding. On the other hand, monozygotic (and especially monochorionic) pregnancies have been found to entail higher levels of maternal stress, anxiety, and depression than dizygotic pregnancies, due to signif-icantly higher medical risk, and these symptoms can put the dyad at risk for poor maternal-infant bonding (for a review, see Ionio et al, 2022). Thus, it is unclear whether zygosity might be linked with potential maternal-infant bonding discrepancies.…”

“…Prior work suggests that self‐reported maternal‐infant bonding is, on average, lower in mothers of twins than in mothers of singletons (Wenze et al., 2023), and behavioral observation has found that mothers of twins demonstrate lower sensitivity and more distant behaviors while interacting with their babies (Ionio et al., 2022). Mothers of twins commonly report feelings of loss, grief, and guilt over insufficient time to bond individually with both of their babies (Gowling et al., 2021; Holditch‐Davis et al., 1999; Wenze et al., 2020).…”