Childbirth-related post-traumatic stress disorder symptoms and mother–infant neurophysiological and behavioral co-regulation during dyadic interaction: study protocol

BACKGROUND: Mother’s childbirth-related posttraumatic stress disorder (PTSD) symptoms have a negative impact on mother and infant’s behaviors during dyadic interactions which may increase mother–infant neurophysiological and behavioral co-regulation difficulties, leading to dysregulated mother–infant interactions. This study was specifically designed to analyze: (1) the sociodemographic and obstetric factors associated with mother’s childbirth-related PTSD symptoms; (2) mother–infant neurophysiological functioning and behavioral co-regulation during dyadic interaction; (3) the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; (4) the moderator role of previous trauma on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction; and (5) the moderator role of comorbid symptoms of anxiety and depression on the impact of mother’s childbirth-related PTSD symptoms on neurophysiological and behavioral mother–infant co-regulation during dyadic interaction. METHODS: At least 250 mothers will be contacted in order to account for refusals and dropouts and guarantee at least 100 participating mother–infant dyads with all the assessment waves completed. The study has a longitudinal design with three assessment waves: (1) 1–3 days postpartum, (2) 8 weeks postpartum, and (3) 22 weeks postpartum. Between 1 and 3 days postpartum, mothers will report on-site on their sociodemographic and obstetric characteristics. At 8 weeks postpartum, mothers will complete online self-reported measures of birth trauma, previous trauma, childbirth-related PTSD, anxiety, and depressive symptoms. At 22 weeks postpartum, mothers will complete online self-reported measures of childbirth-related PTSD, anxiety, and depressive symptoms. Mothers and infants will then be home-visited to observe and record their neurophysiological, neuroimaging and behavioral data during dyadic interactions using the Still-face Paradigm. Activation patterns in the prefrontal cortices of mother and infant will be recorded simultaneously using hyperscanning acquisition devices. Unadjusted and adjusted multilevel linear regression models will be performed to analyze objectives 1 to 3. Moderation models will be performed to analyze objectives 4 and 5. DISCUSSION: Data from this study will inform psychological interventions targeting mother–infant interaction, co-regulation, and infant development. Moreover, these results can contribute to designing effective screenings to identify mothers at risk of perinatal mental health problems and those who may need specialized perinatal mental health care.