Abstract 

Background: The Newborn Behaviour Observation system (NBO) is a flexible relationship-based intervention designed to sensitise parents to their newborn’s capacities, to increase parental confidence and foster the bond between parent and infant. The aim of this study was to investigate the effects of an NBO intervention on maternal confidence during the first month postpartum, and on the quality of mother-infant interaction at infant age 4 months in a sample of mothers who exhibit elevated signs of distress or depression during pregnancy and/or describe prior experiences of mental health issues. 

Method: Pregnant women with current emotional distress and/or a history of anxiety and depression were recruited from a healthcare centre in Reykjavik, between August 2016 and April 2018. The study used a two-group, randomized trial design with six measuring points, in which 54 women were randomly assigned to either the intervention or control group. The intervention group (n=26) received the NBO in combination with standard care during routine home visits. The control group (n=28) received the same numbers of home visits with standard care without NBO. Maternal confidence was measured using a parent questionnaire (covering learning outcomes relating to the infant’s communicative signals and maternal confidence) administered after each home visit in weeks 2, 3 and 4 postpartum. At 4 months infant age, a free-play situation involving mother-infant interaction was video-recorded in the participants’ homes and coded using the Emotional Availability Scale (EAS). Mixed effects models were used 

to estimate group differences in learning outcomes and maternal confidence across three time points. Two sample t-tests were used to compare the two groups’ EAS scores.