Dependência materna do smartphone e vínculo afetivo mãe-bebê no alojamento conjunto de uma maternidade terciária

Abstract

Smartphone use in the postpartum period can be distracting and negatively impact emotional bonding. In this context, this study aimed to evaluate the correlation between maternal smartphone dependence, mother-baby emotional bonding, and mental health during hospitalization in shared accommodation. This was a cross-sectional, analytical, quantitative study. The inclusion criteria comprised postpartum women with access to smartphones, with children aged two days or older, in shared accommodation. The exclusion criteria were postpartum women with severe mental disorders and/or drug users, except marijuana. Socioeconomic and demographic questionnaires were applied, as well as the Brazilian versions of the Smartphone Addiction Inventory (SPAI-BR) to screen for maternal smartphone dependence; the Postpartum Bonding Questionnaire (PBQ-BR) to assess mother-baby bonding in the postpartum period; and the Self-Report Questionnaire (SRQ-20) to screen for mental distress. It was a consecutive sampling with 318 postpartum women interviewed between July and September 2024. The Ethics Committee approved the study under opinion 6.918.129. Data was managed in REDCap® and presented as mean and absolute frequency. The Wilcoxon rank-sum test, Fisher’s exact test, Chi-square test of independence, multivariate Poisson regression with Odds Ratio analysis, Variance Inflation Factor, and 95% confidence interval were applied. Results revealed that 156 (49%) postpartum women presented smartphone dependence, 72 (23%) had impaired emotional bonding, and 171 (54%) reported mental distress. Smartphone dependence was more prevalent in postpartum women aged between 18 and 34 years (133-85.26%, p<0.001). There was a statistical association (p<0.001) between the total PBQ-BR score and its factors 1 (impaired bonding), 2 (rejection and pathological anger), 3 (infant focused anxiety), 4 (incipient abuse) and maternal smartphone dependence, with the mean SPAI-BR score (p<0.001). Regarding mental distress, all categories, 1, 2, 3 and 4 (lack of energy, somatic symptoms, depressive state, and depressive thoughts) were statistically associated with smartphone dependence (p<0.001). The SPAI-BR dimensions (1-compulsive behavior, 2-functional behavior, 3-withdrawal syndrome, and 4-tolerance syndrome) were associated with impaired emotional bonding (p<0.001). There was a statistical association (p<0.001) between maternal smartphone dependence (in the total score and in all dimensions) and impaired emotional bonding. Mental distress and impaired emotional bonding were statistically associated (p<0.001) in the total score and in categories 1 and 4. Factor 3 “infant focused anxiety” of the PBQ-BR presented a statistical association with smartphone dependence (p=0.033). Category 4 “somatic symptoms” was the only variable statistically associated with smartphone dependence (p=0.038). Multivariate Poisson regression identified that infant focused anxiety (p=0.033) and somatic symptoms from the SRQ-20 (p=0.038) were significantly associated with smartphone dependence. Therefore, it was concluded that maternal smartphone dependence is associated with impaired emotional bonding and maternal mental distress, reinforcing the need for maternal awareness about the impact of excessive smartphone use in the postpartum period and the importance of public policies aimed at maternal mental health and the conscious use of technology.