Supporting the adolescent mother–infant relationship: preliminary trial of a brief perinatal attachment intervention

2013 
The purpose of this study is to test a brief, attachment intervention added to routine maternity care that aims to improve the adolescent mother–infant relationship during transition to motherhood. A pre-test, post-test, peer–control–group trial was set in a large tertiary maternity hospital in Melbourne, Australia. Participants were multi-cultural, pregnant adolescents (n = 97). The two-session ‘AMPLE’ intervention was provided in late pregnancy and neonatally. The main outcome measure was mother–infant interaction quality at age 4 months, blind-coded using the Emotional Availability Scales (EAS) (fourth edition). Study acceptability was high: participation rate 82.9 % and completion rate 75.3 %. Thirty-five participants received the intervention plus usual care (intervention group) and 38 received usual care (control group). There were no pre-test between-group differences across demographic, psychosocial or obstetric domains. At post-test, mother–infant interaction was significantly better in the intervention group. MANOVA analyses showed an overall intervention effect on emotional availability in 20 min of free play (n = 73), F (6,65) = 5.05, p < .01, partial η2 = .32, and in 25 min of play plus brief separation–reunion (n = 55), F (6,48) = 2.72, p = .02, partial η2 = .25. T tests showed significant between-group differences in specific EAS subscales. All effect sizes were medium–large. This promising intervention appears to exert a clinically meaningful effect on the adolescent mother–infant relationship. Further research is warranted to replicate the findings and confirm causality. The study suggests a brief attachment focus, incorporated into routine maternity care, could influence the developmental trajectory of infants of young mothers from birth.
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