Disorganised attachment behaviour among infants born subsequent to stillbirth

There is limited evidence that siblings of stillborn infants are more vulne rable to psychological problems. This case-controlled study examines the re lationship between previous stillbirth and the next child's pattern of atta chment and explores factors in the mother which may be associated with and which may explain the pattern of infant attachment. We examined 53 infants next-born after a stillbirth, and 53 control infants of primigravid mothers . Maternal demographic, psychiatric, and attachment data were collected in pregnancy, and self-report measures of depression collected in the first ye ar. Infant attachment patterns to the mothers were assessed when the infant s were 12 months old using the Ainsworth Strange Situation Procedure. Infan ts next-born after stillbirth showed significant increase in disorganisatio n of attachment to the mother compared with control infants (p < .04). The difference was not accounted for by differences in psychiatric symptoms or demography. It was strongly predicted by maternal unresolved status with re spect to loss as measured in the Adult Attachment Interview, and less stron gly by maternal experience of elective termination of pregnancy and by the mother having seen her stillborn infant. The study adds weight to previousl y reported clinical observations, that infants born after stillbirth may be at risk of an increase in psychological and behavioural problems in later childhood. The strong association between disorganisation of infant attachm ent and maternal state of mind with respect to loss suggests that the mothe r's state of mind may be causal, and raises interesting questions about the mechanism of intergenerational transmission. Given the existing evidence o f later developmental problems, longer-term follow-up of these children wou ld be valuable.