Reviewer's report
Title:Effect of previous perinatal loss on maternal-infant bonding during the first
year postpartum in the First Baby Study: A longitudinal cohort study
Version:3Date:20 May 2014
Reviewer: Sylvia Metcalfe
Reviewer's report:
This is a well written article reporting further data from a longitudinal cohort study
of women giving birth to their first live-born child. This article is one of several
published or under review based on data collected from this cohort.
The authors tested the hypothesis that women with a history of perinatal loss
have decreased maternal-infant bonding at each time point (1, 6 and 12 months
post-partum) compared to women without a history of perinatal loss. Their
findings did not support this hypothesis.
Major Compulsory Revisions
1.
Overall this seems a well designed study, however I have a concern regarding
the outcome variable, maternal-infant bonding, which the authors report was
measured using a ten-item shortened version of the Postpartum Bonding
Questionnaire. While the original scale was developed and validated previously
by other researchers, the authors calculated the Cronbach’s alpha in this study,
which was not particularly high (0.672) and certainly lower than that of other
measures used. The authors refer to another of their manuscripts for details of
the scale development and psychometric properties, as used for this cohort,
however the manuscript is currently under review (reference 34: Bicking Kinsey
C, Baptiste-Roberts K, Zhu J, Kjerulff K: Birth-related, psychosocial, and
emotional correlates of positive maternal-infant bonding in a cohort of first-time
mothers, Midwifery under review). This makes it very difficult to assess the
validity of the scale in the present study and is potentially problematic as this is
the measure for the main outcome reported here.
The authors should report more details of the psychometric properties in this
manuscript to allow for a better assessment of the value of this measure in this
study or consider delaying publishing this manuscript until reference 34 is at least
accepted and preferably published.
2.
The authors provided the background, theoretical basis (ie Ramona Mercer’s
theory of Becoming a Mother) and other studies that led to their hypothesis. Their
findings did not support this hypothesis and there was a brief mention in the
Discussion that “when a perinatal loss occurs, providing disruption in the first
stage of the process of becoming a mother, most women are able to cope in
such a way that they achieve all four stages in a healthy manner during a
subsequent pregnancy. Our study indicates that women with a history of
perinatal loss are resilient and able to form a healthy bond with their subsequent
infant.” However, the authors did not measure resilience or coping and the
discussion around this as a possible explanation is quite cursory and merits
further argument, including consideration of other possible explanations.
Minor Revisions
Typographical error
Page 9, line 8 of para:“The data was examined…..” should be “The data were
examined…..”
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare I have no competing interests