Identification of Bonding Difficulties in the Peripartum Period Using the Mother-to-Infant Bonding Scale-Japanese Version and Its Tentative Cutoff Points

Koyo Hashijiri,1 Yuichiro Watanabe,1 Naoki Fukui,1 Takaharu Motegi,1 Maki Ogawa,1 Jun Egawa,1 Takayuki Enomoto,2 Toshiyuki Someya1 1Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 2Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JapanCorrespondence: Yuichiro Watanabe Email yuichiro@med.niigata-u.ac.jpPurpose: Identification of pregnant women with bonding difficulties is important to provide early intervention. However, few studies have examined the utility of self-report questionnaires that assess mother–infant bonding as screening tools for bonding difficulties. This longitudinal study aimed to identify pregnant women with bonding difficulties using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) and to estimate its optimal cutoff points in the peripartum period.Patients and Methods: A total of 1301 pregnant women completed the MIBS-J and Hospital Anxiety and Depression Scale (HADS) at three time points: first trimester (T1; approximately 12– 15 weeks gestation), third trimester (T2; approximately 30– 34 weeks gestation), and postpartum (T3; approximately 4 weeks postpartum). A two-step cluster analysis was conducted to classify pregnant women based on their MIBS-J subscale scores at the three time points. Based on the cluster analysis results, receiver operating characteristic curve analysis was performed to estimate the optimal cutoff scores for the MIBS-J total score at each time point.Results: The two-step cluster analysis produced two clusters: Cluster 1 (n = 824) and Cluster 2 (n = 477). Both the MIBS-J and HADS scores were significantly higher in Cluster 2 than in Cluster 1 at all time points. The MIBS-J tentative cutoff points were 3/4, 3/4, and 2/3 at T1, T2, and T3, respectively.Conclusion: We identified two distinct groups across the perinatal period: pregnant women with bonding difficulties and pregnant women with normal bonding. Our findings suggest the usefulness of the MIBS-J as a screening tool to identify bonding difficulties during pregnancy.Keywords: bonding difficulties, cluster analysis, HADS, MIBS-J, ROC analysis