{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:18:23Z","timestamp":1785550703883,"version":"3.56.0"},"reference-count":51,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fogarty International Center of the National Institutes of Health","award":["1R25TW011213"],"award-info":[{"award-number":["1R25TW011213"]}]},{"name":"National Institutes of Health","award":["1R25TW011213"],"award-info":[{"award-number":["1R25TW011213"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Impaired maternal\u2013infant bonding can have a negative impact on the mother\u2013infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal\u2013infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal\u2013infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal\u2013infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score \u2265 13 on the PBQ were considered to have impaired maternal\u2013infant bonding. The prevalence of impaired maternal\u2013infant bonding among mothers was 45% (190\/422). Logistic regression was used to determine factors associated with impaired maternal\u2013infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03\u20134.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07\u20138.82], p &lt; 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37\u20134.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13\u20132.86], p = 0.013), mothers with no\/low education levels (AOR = 2.29, 95% [CI = 1.05\u20134.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10\u20135.67], p = 0.028) were more likely to have impaired maternal\u2013infant bonding. Nurses and midwives in postnatal care should include maternal\u2013infant bonding within their client\u2019s assessment and provide supportive mother-centered care. Interventions to improve maternal\u2013infant bonding should be created and implemented in clinical practice.<\/jats:p>","DOI":"10.3390\/ijerph21060665","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T05:35:20Z","timestamp":1716442520000},"page":"665","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and Factors Associated with Impaired Maternal\u2013Infant Bonding among Mothers Attending Young Child Clinic in Kampala, Uganda"],"prefix":"10.3390","volume":"21","author":[{"given":"Phionah","family":"Tukamushabe","sequence":"first","affiliation":[{"name":"Department of Nursing, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom Denis","family":"Ngabirano","sequence":"additional","affiliation":[{"name":"Department of Nursing, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce Nankumbi","family":"Okonya","sequence":"additional","affiliation":[{"name":"Department of Nursing, Makerere University, Kampala P.O. Box 7072, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0385-4864","authenticated-orcid":false,"given":"Melissa A.","family":"Saftner","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"ref_1","unstructured":"Klaus, M.H., and Kennell, J.H. (1976). Maternal-Infant Bonding: The Impact of Early Separation or Loss on Family Development, Mosby."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"893505","DOI":"10.3389\/fpsyt.2022.893505","article-title":"Mother-Infant Bonding and Its Associated Factors Among Mothers in the Postpartum Period, Northwest Ethiopia, 2021","volume":"13","author":"Hailemeskel","year":"2022","journal-title":"Front. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/2047-3095.12235","article-title":"The Maternal\u2013Infant Bond: Clarifying the Concept","volume":"31","author":"Hill","year":"2020","journal-title":"Int. J. Nurs. Knowl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.midw.2012.12.019","article-title":"State of the science of maternal\u2013infant bonding: A principle-based concept analysis","volume":"29","author":"Hupcey","year":"2013","journal-title":"Midwifery"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3153","DOI":"10.1080\/14767058.2017.1365130","article-title":"Maternal\u2013foetal attachment independently predicts the quality of maternal\u2013infant bonding and post-partum psychopathology","volume":"31","author":"Petri","year":"2018","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"126","DOI":"10.32725\/kont.2021.018","article-title":"Mother-infant bonding and its associated factors during postpartum period","volume":"23","year":"2021","journal-title":"Kontakt"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"433","DOI":"10.24869\/psyd.2018.433","article-title":"Level of mother-baby bonding and influencing factors during pregnancy and postpartum period","volume":"30","author":"Daglar","year":"2018","journal-title":"Psychiatr. Danub."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/infa.12068","article-title":"Trajectories of Regulatory Behaviors in Early Infancy: Determinants of Infant Self-Distraction and Self-Comforting","volume":"20","author":"Planalp","year":"2015","journal-title":"Infancy"},{"key":"ref_9","unstructured":"Johnson, K. (2013). Maternal-Infant Bonding: A Review of Literature. Int. J. Childbirth Educ., 28, Available online: https:\/\/go.gale.com\/ps\/i.do?id=GALE%7CA344155224&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=08878625&p=AONE&sw=w&userGroupName=anon%7E6e8f4fc4&aty=open-web-entry."},{"key":"ref_10","first-page":"13","article-title":"Predictors of Mother-Child Bonding","volume":"22","author":"Galeshi","year":"2016","journal-title":"Hayat"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00737-015-0589-x","article-title":"Assessment of psychometric properties of the Postpartum Bonding Questionnaire (PBQ) in Spanish mothers","volume":"19","author":"Torres","year":"2016","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"290","DOI":"10.4103\/0019-5545.166621","article-title":"The establishment of a mother-baby inpatient psychiatry unit in India: Adaptation of a Western model to meet local cultural and resource needs","volume":"57","author":"Chandra","year":"2015","journal-title":"Indian J. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Nakano, M., Upadhyaya, S., Chudal, R., Skokauskas, N., Luntamo, T., Sourander, A., and Kaneko, H. (2019). Risk factors for impaired maternal bonding when infants are 3 months old: A longitudinal population based study from Japan. BMC Psychiatry, 19.","DOI":"10.1186\/s12888-019-2068-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1017\/SJP.2021.44","article-title":"External Validation and Test-Retest Reliability of Postpartum Bonding Questionnaire in Spanish Mothers","volume":"24","author":"Sureda","year":"2021","journal-title":"Span. J. Psychol."},{"key":"ref_15","first-page":"318","article-title":"Factors Associated With Postpartum Maternal Infant-Bonding","volume":"7","author":"Elwadood","year":"2020","journal-title":"Int. J. Nov. Res. Healthc. Nurs."},{"key":"ref_16","unstructured":"Frerichs, R.R. (2022, August 05). Rapid Surveys [Internet]. Available online: https:\/\/www.ph.ucla.edu\/epi\/rapidsurveys\/RScourse\/RSbook_ch3.pdf."},{"key":"ref_17","unstructured":"Kish, L. (1965). Survey Sampling, John Wiley and Sons, Inc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s00737-006-0132-1","article-title":"The Postpartum Bonding Questionnaire: A validation","volume":"9","author":"Brockington","year":"2006","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s00737-009-0140-z","article-title":"Three self-report questionnaires of the early mother-to-infant bond: Reliability and validity of the Dutch version of the MPAS, PBQ and MIBS","volume":"13","author":"Spitz","year":"2010","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.4236\/psych.2014.59126","article-title":"The Psychometric Properties and Factor Structure of the Postpartum Bonding Questionnaire in Japanese Mothers","volume":"05","author":"Kaneko","year":"2014","journal-title":"Psychology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ohashi, Y., Kitamura, T., Sakanashi, K., and Tanaka, T. (2016). Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants. Healthcare, 4.","DOI":"10.3390\/healthcare4030050"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00737-006-0144-x","article-title":"The German version of the Postpartum Bonding Instrument: Psychometric properties and association with postpartum depression","volume":"9","author":"Reck","year":"2006","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/NMD.0b013e3181d14154","article-title":"Impairment of Mother-Infant Relationship: Validation of the Chinese Version of Postpartum Bonding Questionnaire","volume":"198","author":"Siu","year":"2010","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jpsychores.2015.02.008","article-title":"The Japanese version of the Postpartum Bonding Questionnaire: Examination of the reliability, validity, and scale structure","volume":"79","author":"Suetsugu","year":"2015","journal-title":"J. Psychosom. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.22158\/rhs.v4n3p221","article-title":"Assessment of Psychometric Properties of the Postpartum Bonding Questionnaire (PBQ) in Jordanian Mothers","volume":"4","author":"Thekrallah","year":"2019","journal-title":"Res. Health Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ajp.2019.07.004","article-title":"Frequency and correlates of mother-infant bonding disorders among postpartum women in India","volume":"44","author":"Vengadavaradan","year":"2019","journal-title":"Asian J. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/02646830802350831","article-title":"The effect of post-natal symptoms of post-traumatic stress and depression on the couple\u2019s relationship and parent\u2013baby bond","volume":"27","author":"Parfitt","year":"2009","journal-title":"J. Reprod. Infant Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s007370170010","article-title":"A Screening Questionnaire for mother-infant bonding disorders","volume":"3","author":"Brockington","year":"2001","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1080\/02646839808404558","article-title":"The assessment of parent-to-infant attachment: Development of a self-report questionnaire instrument","volume":"16","author":"Condon","year":"1998","journal-title":"J. Reprod. Infant Psychol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00737-005-0074-z","article-title":"A new Mother-to-Infant Bonding Scale: Links with early maternal mood","volume":"8","author":"Taylor","year":"2005","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00737-016-0602-z","article-title":"Predictors of postnatal mother-infant bonding: The role of antenatal bonding, maternal substance use and mental health","volume":"19","author":"Rossen","year":"2016","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kim, S., Bang, K.S., Jeong, Y., Lee, G., Shin, D.A., and Kim, M. (2022). The experience of unmarried mothers raising their children in residential facilities: A phenomenological qualitative study. BMC Women\u2019s Health, 22.","DOI":"10.1186\/s12905-022-01727-9"},{"key":"ref_33","unstructured":"(2023, September 12). Uganda Bureau of Statistics and ICF International. Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/fr264\/fr264.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s10995-008-0312-x","article-title":"Mother-to-Infant Emotional Involvement at Birth","volume":"13","author":"Figueiredo","year":"2009","journal-title":"Matern. Child Health J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"687535","DOI":"10.3389\/fpsyt.2021.687535","article-title":"Maternal Bonding in Early Infancy Predicts Childrens\u2019 Social Competences in Preschool Age","volume":"19","author":"Joas","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lehnig, F., Nagl, M., Stepan, H., Wagner, B., and Kersting, A. (2019). Associations of postpartum mother-infant bonding with maternal childhood maltreatment and postpartum mental health: A cross-sectional study. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2426-0"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Korukcu, O. (2018). Identification of Factors Affecting Mother-Infant Bonding in Advanced Maternal Age. LOJNHC, 1, Available online: http:\/\/www.lupinepublishers.com\/nursing-journal\/fulltext\/identification-of-factors-affecting-mother-infant-bonding-in-advanced-maternal-age.ID.000102.php.","DOI":"10.32474\/LOJNHC.2018.01.000102"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00737-014-0445-4","article-title":"Postpartum bonding: The role of perinatal depression, anxiety and maternal\u2013fetal bonding during pregnancy","volume":"18","author":"Dubber","year":"2015","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1016\/j.midw.2014.02.006","article-title":"Birth-related, psychosocial, and emotional correlates of positive maternal-infant bonding in a cohort of first-time mothers","volume":"30","author":"Kinsey","year":"2014","journal-title":"Midwifery"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bieleninik, \u0141., Lutkiewicz, K., Cie\u015blak, M., Preis-Orlikowska, J., and Bidzan, M. (2021). Associations of Maternal-Infant Bonding with Maternal Mental Health, Infant\u2019s Characteristics and Socio-Demographical Variables in the Early Postpartum Period: A Cross-Sectional Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168517"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"105","DOI":"10.5334\/aogh.2524","article-title":"Factors Associated with Mothers\u2019 Care of Their Newborns in Saudi Arabia","volume":"85","author":"Gosadi","year":"2019","journal-title":"Ann. Glob. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1159\/000325058","article-title":"Maternal rejection of the young child: Present status of the clinical syndrome","volume":"44","author":"Brockington","year":"2011","journal-title":"Psychopathology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"68","DOI":"10.5935\/1518-0557.20210029","article-title":"Mother-infant relationship and its Predictors","volume":"26","author":"Darvishvand","year":"2022","journal-title":"JBRA Assist. Reprod."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/sjhs.sjhs_50_18","article-title":"Factors associated with postnatally maternal-infant attachment in taif, Saudi Arabia","volume":"7","author":"Abbas","year":"2018","journal-title":"Saudi J. Health Sci."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Tichelman, E., Westerneng, M., Witteveen, A.B., Van Baar, A.L., Van Der Horst, H.E., De Jonge, A., Berger, M.Y., Schellevis, F.G., Burger, H., and Peters, L.L. (2019). Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222998"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.ijnurstu.2008.10.013","article-title":"A meta-analytic study of predictors of maternal-fetal attachment","volume":"46","author":"Yarcheski","year":"2009","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.nainr.2013.04.001","article-title":"The Sacred Hour: Uninterrupted Skin-to-Skin Contact Immediately After Birth","volume":"13","author":"Phillips","year":"2013","journal-title":"Newborn Infant Nurs. Rev."},{"key":"ref_48","first-page":"36","article-title":"An exploratory study of the views of Ugandan women and health practitioners on the use of sonography to establish fetal sex","volume":"9","author":"Mubuuke","year":"2011","journal-title":"Pan Afr. Med. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/02646838.2018.1436753","article-title":"The relationship between maternal-fetal attachment and maternal self-efficacy in Iranian women: A prospective study","volume":"36","author":"Delavari","year":"2018","journal-title":"J. Reprod. Infant Psychol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Hairston, I.S., Handelzalts, J.E., Lehman-Inbar, T., and Kovo, M. (2019). Mother-infant bonding is not associated with feeding type: A community study sample. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2264-0"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1111\/apa.14754","article-title":"Skin-to-skin contact the first hour after birth, underlying implications and clinical practice","volume":"108","author":"Brimdyr","year":"2019","journal-title":"Acta Paediatr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/665\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:46:57Z","timestamp":1760107617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,23]]},"references-count":51,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["ijerph21060665"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21060665","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,23]]}}}