乳児との対面接触による妊婦の対児感情と不安への効果：ランダム化比較試験

Effect of Face-to-face Contact with Infants on Pregnant Women's Emotions and Anxiety about Infants: A Randomized Controlled Trial

要旨

　目的：乳児とふれ合う経験がない初産婦を対象に，乳児と対面で接触する効果を検証する．

　方法：2群比較のランダム化比較試験．2群は 1）30分間乳児と接触する対面接触群と，2）30分間，乳児の遊び，直接授乳，眠る様子の映像を視聴する映像群である．アウトカムは対児感情評定尺度の接近得点と回避得点，状態不安得点の介入前後の変化量である．

　結果：接近得点は両群で介入後に上昇し，変化量は対面接触群3.5±3.5，映像群1.2±3.6で対面接触群の方が有意に増大し，効果量は中だった（t＝2.896，p＝0.01，d＝0.66）．回避得点と状態不安得点の変化量は，両群に有意な差はなかった（t＝-1.530，p＝0.13，d＝0.34；t＝-1.243，p＝0.22，d＝0.29）．

　結論：2群比較の結果，接近得点の変化量は対面接触群の方が有意に上昇した．両群で介入後の接近得点は上昇，回避得点と状態不安得点は減少した．本結果より，初めて母親になる妊婦と乳児との接触やケアを創る必要がある．

　Objective: To examine the effect of interaction with an infant in primiparas with no experience interacting with infants.

　Method: This two-armed randomized controlled trial compared: 1) 30 minutes of interaction with the infant (face-to-face experience group); and 2) 30 minutes of watching a video on how the infant plays, breastfeeding, and the infant falling asleep (video experience group). The outcomes were the amount of change in the emotion score for approaching infants, the emotion score for avoiding infants, and the anxiety score before and after the intervention.

　Results: The emotion score for approaching infants increased after the intervention for both groups; however, comparing the quantity of change, the score in the face-to-face experience group was 3.5 ± 3.5, and for the video experience group was 1.2 ± 3.6, with the quantity of change significantly greater for the face-to-face experience group with a medium effect size (t = 2.896, p = 0.01, d = 0.66). The emotion score for avoiding infants and the anxiety score decreased in both groups after the intervention; however, the quantity of change was not significantly different between the two groups (t = -1.530, p = 0.13, d = 0.34; t = -1.243, p = 0.22, d = 0.29).

　Conclusion: The amount of change in the approach score was significantly higher in the face-to-face experience group. In both groups, approach scores increased and avoidance scores and state anxiety scores decreased after the intervention. Based on these results, it is necessary to create opportunities for primiparas to interact with infants.