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However, the association of childbirths of infants with cleft lip and\/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infants with cleft lip and\/or palate and mother-to-infant bonding, using data from the Japan Environment and Children\u2019s Study, a nationwide birth cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study using the jecs-an-20,180,131 dataset was performed. A total 104,065 fetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and\/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and\/or palate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and\/or palate (odds ratio [95% confidence interval]; 0.97 [0.63\u20131.48],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and\/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and\/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval]\u2009=\u20092.51 [1.17\u20135.37],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018), but it was weakened after additional adjustment for maternal depression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Childbirths of infants with cleft lip and\/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12887-019-1877-9","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T03:05:23Z","timestamp":1576811123000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Association of cleft lip and palate on mother-to-infant bonding: a cross-sectional study in the Japan Environment and Children\u2019s Study (JECS)"],"prefix":"10.1186","volume":"19","author":[{"name":"Japan Environment & Children\u2019s Study Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinobu","family":"Tsuchiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-4547","authenticated-orcid":false,"given":"Masahiro","family":"Tsuchiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Momma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeyoshi","family":"Koseki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Igarashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoichi","family":"Nagatomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Arima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Yaegashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"1877_CR1","unstructured":"The Centre of the International Clearinghouse for Birth Defects Surveillance and Research. 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The JECS protocol was approved by the Ministry of the Environment\u2019s Institutional Review Board on Epidemiological Studies (no. 100406001), and approved by the ethics committees of all participating institutions (i.e., Asahikawa Medical College, Chiba University, Doshisha University, Fukushima Medical University, Hokkaido University, Hyogo College of Medicine, Japanese Red Cross Hokkaido College of Nursing, Kochi University, Kumamoto University, Kyoto University, Kyushu University, Nagoya City University, NCCHD, NIES, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka University, Sapporo Medical University, Shinshu University, Tohoku University, Tottori University, University of Occupational and Environmental Health, University of Miyazaki, University of the Ryukyu, University of Toyama, University of Yamanashi, and Yokohama City University). Written informed consent was obtained from all participants. The present study was conducted as a part of JECS and used anonymized data; hence, additional approval from the ethics committee was not required.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"505"}}