Review
Neuroendocrinology of childbirth and mother–child attachment: The basis of an etiopathogenic model of perinatal neurobiological disorders

https://doi.org/10.1016/j.yfrne.2014.03.007Get rights and content

Highlights

  • Labor affects hormonal levels and mother–child attachment.

  • Skin-to-skin contact and breastfeeding affect mother–child attachment.

  • The specific intrapartum hormonal cascade in the maternal brain is still unknown.

  • The interaction with their infants causes higher oxytocin levels in mothers.

  • Several obstetric interventions may alter the peripartal neuroendocrine events.

Abstract

This review focuses on the neuroendocrine mechanisms in the mother and the newborn that are involved in the generation and consolidation of mother–child attachment. The role that different hormones and neurotransmitters play on the regulation of these mechanisms during parturition, the immediate postpartum period and lactation is discussed. Interferences in the initiation of mother–child attachment may have potential long-term effects for the behavior and affection of the newborn. Therefore, the possible consequences of alterations in the physiological neuroendocrine mechanisms of attachment, caused by elective Cesarean section, intrapartum hormonal manipulations, preterm delivery, mother–infant postpartum separation and bottle-feeding instead of breastfeeding are also discussed.

Section snippets

Introduction: Childbirth as a neurobiological and neuroendocrine event

Physiological changes in the dynamics and mechanics of labor in women have been thoroughly studied (Liao et al., 2005). However, the peripartal neurohormonal scenery in the brain of the mother, the fetus and the newborn has received little attention. Here we will approach human childbirth as a neurohormonal event rather than a mechanical one and we will specifically focus on the peripartal neuroendocrine mechanisms that participate in the generation of mother–child attachment. We will also

Oxytocin

Studies in rodents and sheep indicate that the stimulation of the vagina and cervix at birth plays an important role in the induction of maternal behavior (Keverne et al., 1983, Yeo and Keverne, 1986, Kendrick and Keverne, 1991). Vaginal and cervix stimulation also triggers in sheep the formation of olfactory recognition memory that is essential for the selective recognition of lambs and for the formation of maternal bonding (Keverne et al., 1983, Kendrick et al., 1991b). These effects on

Mother–child synchrony: Importance of skin-to-skin contact

Humans are born biologically prepared to establish coordinated interactions from the first hours of life. Right after delivery occurs the so-called sensitive period, a quiet alertness state that lasts for about two hours (Bystrova et al., 2009). The neonatal sensitive period includes the spontaneous onset of breastfeeding in the first two hours of life. The first hours after birth are also a critical period for the development of attachment behavior (Mehler et al., 2011).

In humans, randomized

Consequences for the newborn

Several circumstances may potentially disrupt the neuroendocrine mechanisms of mother–child attachment during the peripartal period in humans (Fig. 2). One of these is the elimination of labor in planed Cesarean sections. The use of Cesarean section for delivery is continuously rising worldwide, often for non medical reasons. Cesarean rates were of 32.8% in the US in 2011 (Hamilton et al., 2013), 48% in China in 2010 (Lumbiganon et al., 2010, Souza et al., 2010) and 45.9% in Brazil and 41.9% in

Conclusions

Childbirth can be considered as a neurohormonal event where both maternal and fetal brains participate and where a specific neurohormonal scenario is settled. The studies reviewed in this paper suggest that hormonal changes in the maternal and the fetal/newborn brains during parturition, the immediate postpartum period and lactation are involved in the generation of mother–child attachment in humans. Several hormones seem to play a key role in the mechanisms of initiation and consolidation of

Acknowledgments

Grant support from the Fondo de Investigaciones Sanitarias (PI10/00791) and Ministerio de Economía y Competitividad, Spain (BFU2011-30217-C03-01).

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