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Original article
Impact of perinatal asphyxia on parental mental health and bonding with the infant: a questionnaire survey of Swiss parents
  1. Antje Horsch1,
  2. Ingo Jacobs2,
  3. Leah Gilbert1,
  4. Céline Favrod1,
  5. Juliane Schneider1,3,
  6. Mathilde Morisod Harari4,
  7. Myriam Bickle Graz1
  8. on behalf of the Asphyxia and Cooling Register Group
  1. 1 Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Vaud, Switzerland
  2. 2 Department of Psychology, Sigmund Freud PrivatUniversität Berlin, Berlin, Germany
  3. 3 Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
  4. 4 Department of Child and Adolescent Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
  1. Correspondence to Dr Antje Horsch; antje.horsch{at}


Objective To compare current mental health symptoms and infant bonding in parents whose infants survived perinatal asphyxia in the last 2 years with control parents and to investigate which sociodemographic, obstetric and neonatal variables correlated with parental mental health and infant bonding in the asphyxia group.

Design Cross-sectional questionnaire survey of parents whose children were registered in the Swiss national Asphyxia and Cooling register and of control parents (Post-traumatic Diagnostic Scale, Hospital Anxiety and Depression Scale, Mother-to-Infant Bonding Scale).

Results The response rate for the asphyxia group was 46.5%. Compared with controls, mothers and fathers in the asphyxia group had a higher frequency of post-traumatic stress disorder (PTSD) symptoms (p<0.001). More mothers (n=28, 56%) had a symptom diagnosis of either full or partial PTSD than controls (n=54, 39%) (p=0.032). Similarly, more fathers (n=31, 51%) had a symptom diagnosis of either partial or full PTSD than controls (n=19, 33%) (p=0.034). Mothers reported poorer bonding with the infant (p=0.043) than controls. Having a trauma in the past was linked to more psychological distress in mothers (r=0.31 (95% CI 0.04 to 0.54)) and fathers (r=0.35 (95% CI 0.05 to 0.59)). For mothers, previous pregnancy was linked to poorer bonding (r=0.41 (95% CI 0.13 to 0.63)). In fathers, therapeutic hypothermia of the infant was related to less frequent PTSD symptoms (r=−0.37 (95% CI −0.61 to −0.06)) and past psychological difficulties (r=0.37 (95% CI 0.07 to 0.60)) to more psychological distress. A lower Apgar score was linked to poorer bonding (r=−0.38 (95% CI −0.64 to −0.05)).

Conclusions Parents of infants hospitalised for perinatal asphyxia are more at risk of developing PTSD than control parents.

  • asphyxia
  • posttraumatic stress disorder
  • mother
  • mental health
  • bonding

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  • Contributors AH had primary responsibility for the study design, data acquisition, analysis and writing of the manuscript and approved the final manuscript as submitted. MBG was involved in the study design, data acquisition and writing of the manuscript and approved the final manuscript as submitted. IJ was responsible for the statistical expertise, performed all final statistical analyses, contributed to the writing of the manuscript and approved the final manuscript as submitted. CF and LG contributed to the data analysis, critically reviewed and revised the manuscript and approved the final manuscript as submitted. JS and MMH contributed to the interpretation of data, critically reviewed and revised the manuscript and approved the final manuscript as submitted.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the cantonal ethical review board (Vaud) and by the Swiss Federal Commission for Privacy Protection in Medical Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets analysed during the current study are available from the corresponding author on reasonable request.

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