Labour and delivery characteristics, maternal birth satisfaction and early relational health among COVID-19 pandemic-born children

AIMS/BACKGROUND: Medical events during birth and self-reported birth experience may influence early relational health (ERH) in the postpartum period. Limited longitudinal work has been conducted in this area, particularly among women who gave birth during the COVID-19 pandemic. The goal of this study was to assess labour and delivery characteristics and maternal birth satisfaction as predictors of ERH domains of mother-reported bonding and observed emotional connection in the first year of life among women who gave birth during the COVID-19 pandemic. DESIGN/METHODS: = 384) with and without SARS-CoV-2 infection during pregnancy who gave birth at three U.S.-based academic medical centres who were enrolled in the Epidemiology of Severe Acute Respiratory Syndrome Coronavirus-2 in Pregnancy and Infancy COVID-19 Mother Baby Outcomes (ESPI COMBO) Study. Labour and delivery information was abstracted from medical records. Mothers completed surveys assessing birth satisfaction (2 months) and bonding (4 months postpartum). A remote (Zoom) video visit was conducted at 4-6 months postpartum and observed mother-infant emotional connection was coded using the Welch Emotional Connection Screen. We evaluated study aims using structural equation models. RESULTS: Maternal and infant medical risks (e.g. maternal complications, unplanned caesarean deliveries, care escalation) were associated with lower maternal birth satisfaction, which in turn predicted lower mother-reported bonding and observed emotional connection in infancy. CONCLUSION: Results provide insight into perinatal determinants of early relational health among infants born during the COVID-19 pandemic and inform transdisciplinary clinical care approaches to support families and children in the transition to motherhood.