BACKGROUND Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. 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's Study, a nationwide birth cohort study. METHODS 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. RESULTS 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 [0.63-1.48], p = 0.880), 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] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. CONCLUSIONS 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.

中文翻译：

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唇腭裂与母婴关系的关联：日本环境与儿童研究 (JECS) 的一项横断面研究。

背景 唇裂和/或腭裂是最常见的先天性出生缺陷之一，会对母亲的心理状态产生负面影响，并可能因此导致虐待儿童的发生率更高。然而，唇裂和/或腭裂婴儿的分娩与母亲情绪参与的关系仍不清楚。我们利用日本环境与儿童研究（一项全国性出生队列研究）的数据，研究了唇裂和/或腭裂婴儿的分娩与母婴关系之间的关联。方法 使用 jecs-an-20,180,131 数据集进行横断面研究。在获得知情书面同意后，日本 15 个区域中心总共 104,065 名胎儿被纳入研究。母婴关系量表是一个由 10 个项目组成的自我报告量表，用于评估产后一年内的母亲关系。最后，参与者包括 79,140 对母婴，其中 211 名唇裂和/或腭裂婴儿的母亲被纳入我们的分析中。使用对缺失数据进行多重插补的多变量逻辑回归分析来计算优势比和 95% 置信区间，以估计亲子关系障碍与唇裂和/或腭裂分娩之间的关联。结果 在所有唇裂和/或腭裂婴儿的母亲中，没有观察到亲密关系障碍的风险增加（比值比 [95% 置信区间]；0.97 [0.63-1.48]，p = 0.880），然而，高龄产妇或多次产次可能会对结合障碍与唇裂和/或腭裂之间的关联产生不利影响。在结合母亲年龄和胎次进行分层后，仅在高龄经产妇中发现唇裂和/或腭裂与亲子关系障碍存在显着相关性（比值比 [95% 置信区间] = 2.51 [1.17-5.37]，p = 0.018），但在对母亲抑郁症进行额外调整后减弱。结论 唇裂和/或腭裂婴儿的分娩可能会增加高龄经产妇出现亲密关系障碍的风险，这可能是通过母亲抑郁所致。这一发现为提供多学科唇裂护理提供了有价值的信息。