Alteración de la percepción materna sobre el estado nutricional de sus hijos ¿nuevo factor de riesgo cardiovascular? / Perception of child nutritional status by their mothers: a new cardiovascular risk factor?

ANTECEDENTES: La obesidad infantil es un trastorno de prevalencia creciente que predispone a la obesidad, diabetes y enfermedades cardiovasculares en el adulto. Investigaciones recientes relacionan la percepción materna con el estado nutricional real de los niños, encontrando una distorsión entre imagen corporal de sus hijos con malnutrición por exceso (MNPE). MÉTODOS: Estudio descriptivo de corte transversal. La población objetivo fue 320 madres de escolares de 6 a 10 años y se utilizó un muestreo por conveniencia. Se incluyeron madres de hijos con MNPE. Se evaluó la percepción de las madres a través de un pictograma. Se efectuaron mediciones antropométricas de peso, talla y perímetro de cintura (PC), presión arterial (PA), glicemia y colesterol total. En el análisis estadístico se usó Stata 14 y Epidat 4.2. RESULTADOS: La muestra fue conformada por 100 díadas madre/hijo con MNPE. 69% de las madres presentaron escolaridad de enseñanza media, y 68% tenían nivel socioeconómico bajo. Respecto de los niños, 52% eran de sexo femenino, 38% presentaban riesgo de obesidad abdominal y el 47% tenían obesidad abdominal. La glicemia en ayunas estaba alterada en 35%, el colesterol total alterado en 12% y 31% presentaban PA elevada. El 60% de las madres de niños con MNPE subestimaron el estado nutricional de sus hijos. CONCLUSIONES: En relación a los factores de riesgo cardiovascular de los escolares, un alto porcentaje presenta índices de riesgo cardiovascular elevado: obesidad abdominal, PA alterada, colesterol total y glicemias alteradas. La alteración de la percepción materna sobre el estado nutricional de sus hijos, puede repercutir en forma significativa para el desarrollo y mantenimiento de la MNPE y, por consiguiente, constituye un factor de riesgo cardiovascular, estableciendo un punto clave de intervención.

BACKGROUND: Overnutrition in children is increasingly more prevalent and leads to obesity, diabetes and cardiovascular disease in adults. Recent research links distorted maternal perception of nutritional status in their children with the presence of obesity in adulthood). METHODS: A descriptive cross-sectional study was performed on mothers and their schoolchildren aged 6 to 10 years old. A basic inclusion criteria was the presence of overnutrition in children and the study related maternal perception with the actual degree of overnutrition in her child. Perception was evaluated using a pictogram. Weight, height, waist circumference, blood pressure (BP), blood sugar level and total cholesterol were measured in children Stata 14 and Epidat 2.0 were used for statistical analysis. RESULTS: 100 mother-child pairs were studied. All children had overnutrition. 69% of mothers had high-school level education and 68% belonged in the low socio-economic stratum. There were 52% of girls. According to waist circumference 38% were at risk of malnutrition and 47% already had abdominal obesity. 35% had an altered fasting blood sugar level, 12% an elevated total cholesterol, 31% an increased blood pressure. 60% of mothers of children with overnutrition underestimated the actual nutritional status (overnutrion) of their children. CONCLUSIONS: The presence of overnutrition and obesity indicators were high in this population. This occurred along with increased levels of BP, total cholesterol and altered blood sugar levels. The maternal perception of their children severely under estimated the level of overnutrition. This fact can have a significant impact on the development and maintenance of the excess type malnutrition and subsequent development of other cardiovascular risk factors. Therefore, improving the perception of mothers regarding the nutritional status of their children should be an important element for diminishing cardiovascular risk longterm.

Leitura materna sobre depressão pós-parto e sintomas psicofuncionais: um caso de psicoterapia mãe-bebê / Maternal perception about postpartum depression and psychofunctional symptoms: a case of mother-baby psychotherapy / Comprensión materna sobre depresión postparto y síntomas psicofuncionales: un caso de psicoterapia madre-bebé

Este estudo investigou as mudanças na leitura materna sobre seus sintomas depressivos e sobre os sintomas psicofuncionais do bebê num contexto de psicoterapia mãe-bebê em grupo. Participaram uma díade mãe-bebê em que a mãe apresentava depressão pós-parto e o bebê sintomas psicofuncionais. Os instrumentos empregados foram a Escala de Depressão Pós-Parto de Edimburgo (EPDS), Entrevista MINI, Entrevista sobre a Gestação e Parto, Entrevista sobre a Experiência da Maternidade e o questionário Symptom Check List (SCL). Foi utilizado o delineamento de estudo de caso único e realizada uma análise qualitativa, relacionando os materiais clínicos das onze sessões de psicoterapia com a literatura a partir de uma compreensão psicanalítica. Os resultados revelaram que os sintomas depressivos maternos e os sintomas psicofuncionais do bebê estavam mutuamente associados e que, a partir da intervenção utilizada, a leitura materna sobre seus sintomas e os do bebê foi modificada, associada a uma melhora dos sintomas em ambos.

This study examined the changes in maternal perception about her own depressive symptoms and the baby's psychofunctional symptoms in a context of mother-baby group psychotherapy. Participants were a mother-baby dyad in which the mother presented postpartum depression and the baby had psychofunctional symptoms. The instruments employed were: EPDS, MINI Interview, Interview on Pregnancy and Childbirth, Interview of the Maternity Experience, and SCL questionnaire. The single-case study design was used and a qualitative analysis was carried out, correlating the clinical materials from the eleven psychotherapy sessions with the theoretical knowledge found in the literature, based on a psychoanalytic understanding. The results revealed that the maternal depressive symptoms and the baby's psychofunctional symptoms were mutually associated and that, through the intervention, the maternal perception about her symptoms and the baby's was modified, associated with an improvement of the symptoms in both.

Este estudio investigó los cambios en la comprensión materna sobre sus síntomas depresivos y sobre los síntomas psicofuncionales del bebé en un contexto de psicoterapia madre-bebé en grupo. Participaron una díada madre-bebé en la que la madre presentaba depresión posparto y el bebé síntomas psicofuncionales. Los instrumentos utilizados fueron: EPDS, Entrevista MINI, Entrevista sobre la Gestación y el Parto, Entrevista sobre la Experiencia de la Maternidad y el cuestionario SCL. Se utilizó el delineamiento de estudio de caso único y realizó un análisis cualitativo, relacionando los materiales clínicos de las once sesiones de psicoterapia con la literatura a partir de una comprensión psicoanalítica. Los resultados revelaron que los síntomas depresivos maternos y los síntomas psicofuncionales del bebé estaban mutuamente asociados y que, a partir de la intervención utilizada, la comprensión materna sobre sus síntomas y del bebé fue modificada, asociada a una mejoría de los síntomas en ambos.

Percepción materna sobre el estado nutricional en escolares de 5 a 6 años pertenecientes a establecimientos de educación especial en la ciudad de Arica / Maternal perception of nutritional condition in students of 5 to 6 years old belonging to special education facilities from the city of Arica

La obesidad corresponde a la acumulación anormal de grasa en el organismo, además es un importante factor de riesgo para el desarrollo de enfermedades cardiovasculares, diabetes, cáncer, etc. En Chile, su prevalencia ha aumentado a lo largo de los años llegando a 24,4% en menores de primer año básico en el año 2018. Hay estudios que reportan que la distorsión de la percepción materna de la imagen corporal del niño podría ser un factor de riesgo para el desarrollo de obesidad infantil ya que de ella dependen principalmente los hábitos alimenticios que el niño adquiera. La sociedad y cultura en la que se desarrolle el individuo también juegan un rol fundamental. El objetivo del estudio fue analizar la percepción materna de la imagen corporal sobre el estado nutricional real del niño con necesidades educativas especiales. La investigación tuvo un diseño observacional de corte transversal. El estudio se realizó en 60 escolares, de 5 y 6 años de edad, pertenecientes a 5 establecimientos de educación especial en la ciudad de Arica. Se aplicó un cuestionario a las madres sobre su percepción del estado nutricional de sus hijos mediante siluetas y conceptos, luego se evaluó peso y estatura en los escolares. Se observó una prevalencia de 38,3% de malnutrición por exceso en la muestra de escolares con necesidades educativas especiales. Además, destaca que un 71,7% de las madres fueron capaces de reconocer el concepto que corresponde al estado nutricional real de su hijo, mientras que un 46,6% lo identificó por medio del uso de siluetas. Se concluyó que las madres con alteración de la percepción materna sobre el estado nutricional de los escolares muestran una tendencia a percibir a su hijo con sobrepeso u obesidad cuando se encuentra en la categoría normal.

Obesity corresponds to the abnormal accumulation of fat, negative situations for health. In childhood, it is an important risk factor for the development of cardiovascular diseases, diabetes, cancer, etc. In Chile, its prevalence has increased over the years reaching 24.4% in children of the first basic year in 2018. Studies indicate that the discrimination of the maternal perception of the child's body image could be a risk factor for the development of childhood obesity that depends on the eating habits that the child acquires. The society and culture in which the individual develops also plays a fundamental role. The objective of the study was to analyze the maternal perception of the body image on the real nutritional status of the child with special educational needs. The research has an observational and transversal design. The study was conducted in 60 students between 5 and 6 years old belonging to 5 special education establishments in the city of Arica. A questionnaire was applied to the mothers about their perception of the nutritional status of their children through silhouettes and concepts, then weight and height were evaluated in schoolchildren. A prevalence of 38.3% of excess malnutrition was observed in the sample of schoolchildren with special educational needs. In addition, it is highlighted that 71.7% of the mothers were able to recognize the concept that corresponds to the actual nutritional status of their child, while 46.6% identified it through the use of silhouettes. We concluded that mothers with an altered maternal perception of the nutritional status of schoolchildren show a tendency to perceive their child as overweight or obese when it is in the normal category.

The Value of Cardiotocography for Evaluation of Fetal Condition and Outcome in Women Presenting with Less Fetal Movement

Objective: In this study our main goal is to determine the valueof cardiotocography for evaluation of fetal condition andoutcome in women presenting with less fetal movement.Method: This cross-sectional study was done at Department ofObstetrics and Gynaecology, Bangabandhu Sheikh MujibMedical University (BSMMU), Dhaka between June 2015 -December 2016. Where women >34 weeks’ gestation withsingleton pregnancies presenting during the study period withmaternal perception of less fetal movement (LFM) in the outpatient Department of Obstetrics and Gynecology in BSMMU.Results: During the study, the mean age was found25.61±5.65 years varied from 19 to 38 years in normal CTGand 24.82±3.81 years varied from 19 to 38 years in abnormalCTG. Majority patients were primiparous in both groups (56.0%vs. 52.0%). More than half (52.0%) of the patients in normalCTG and a half (50.0%) in abnormal CTG patients were camefrom lower middle-income group family. Emergency caesareansection was 12.0% and 42.0% in normal and abnormal CTGrespectively. Emergency caesarean section was significantlyhigher in abnormal CTG. At 1-minute APGAR score £7 wasfound 94.0% babies in normal CTG and 78.0% in abnormalCTG. Needed resuscitation was 4.0% in normal CTG and22.0% in abnormal CTG. Admission to NICU 10.0% babies innormal CTG and 36.0% in abnormal CTG.Conclusions: Decelerations, tachycardia and non-reactive(absent of accelerations) were the more common types ofabnormal CTG. Emergency caesarean section, low APGARscore, needed resuscitation, admission to NICU and prolongedhospital stay were higher in abnormal CTG. CTG can becontinued as a good screening test of fetal surveillance but it isnot the sole criteria to influence the management of high-riskpregnancies.

Inappropriate maternal perception of child's weight status: a potential threat to nutrition

Background: This study was done to know the maternal perception of weight of their children and correlate it with exact weights. We also studied various factors affecting ability of a mother to perceive her child's weight status.Method: This prospective study was done in Pediatric Department of a tertiary care teaching hospital of Western Gujarat, India, from January 2018 to September 2018. 897 mothers of children < 5 years of age were included. Socio-demographic and anthropometric details of child and mother were recorded. Maternal perception of their child's weight status was enquired. A correlation between perceived and actual child weight status was estimated.Results: 897 patients <5 years of age had mean (SD) age of 28.66 ('17.04) months, weight 10.17 ('3.5) kg, height 0.81 ('0.15) meters and BMI 15.74 ('15.26) kg/m2. 34.7% of mothers perceived underweight erroneously as compared to actual weight status being normal (p value=0.00001). Misperception (under or over) of the mothers for their children weight status was significant for girls (p=0.011). Significant difference between perceived and actual weight status was seen in birth orders 1 to 4. 34. 6% actual UW children were perceived as NW by < 40 years age mothers (p=0.0018). 78.2% uneducated and 81% of primary or secondary educated mothers from lower SES felt their children were of NW status whereas actually 43.4% and 50.3% children were of NW status respectively (p=0.00001). Surprisingly, 91.3% of graduate or postgraduate mothers of middle SES perceived their children as NW status while actually only 39.1% were of NW and 52.1% of UW (p=0.00001).Conclusion: Half of the mothers were not able to perceive correct weight status of their children. Misperception was significant for girls. Significant difference between perceived and actual weight status was seen for birth orders 1 to 4. Mothers <40 years of age significantly failed to perceive actual UW status of the children. Both educated and uneducated mothers misclassified their children's weight status significantly.

Concordancia entre la percepción materna y el estado nutricional de sus hijos antes y después de una intervención educativa / Concordance between maternal perception and child's nutritional status before and after an educational intervention

RESUMEN La malnutrición por exceso es un problema de salud y su rápida pesquisa mediante percepción materna (PM), permite intervenciones tempranas enfocadas a disminuir sus consecuencias y costos asociados. El objetivo fue determinar la concordancia entre PM y estado nutricional (EN) de sus hijos, antes y después de una intervención educativa. Participaron 116 diadas madre-hijo de 2 a 5 años, de 4 jardines de Viña del Mar, donde se determinó EN y PM mediante imágenes corporales de los niños. Posteriormente, 57 madres con PM erradas respecto a estado nutricional de su hijo participaron de una intervención educativa de 40 minutos cada 15 días por 3 meses. La concordancia entre el PM y estado nutricional fue evaluada con el test de Kappa. El EN de los niños fue: 3,4% bajo peso; 49,1% normal; 28,4% sobrepeso y 19,0% obesidad. Para la PM el 99,1% subestimó el EN de su hijo (Kappa= 0,022 y p= 0,610). Posterior a la intervención, mejoró la PM en 59,6% y un 40,3% continuó subestimando el EN (kappa= 0,362 y p= 0,000). En este estudio, la PM tiende a subestimar el EN de sus hijos y una intervención educativa mejoró la PM y la concordancia entre PM y el EN de ellos.

ABSTRACT Overnutrition is a health problem and its rapid diagnosis through maternal perception (MP), allows for early intervention focused on reducing consequences and associated costs. The objective of this study was to determine the concordance between MP and child's nutritional status, before and after an educational intervention. Participants were 116 mother-child (2 to 5 years old) dyads from, from 4 daycare centers in Viña del Mar, Chile. Nutritional status was determined and MP was performed using children's body images. Subsequently 57 mothers with MP discordant with child's nutritional status participated in a 40-minute educational intervention every 15 days for 3 months. Concordance between MP and child's nutritional status was evaluated with Kappa. Nutritional status of the 116 children was: 3.4% underweight; 49.1% normal; 28.4% overweight, 19.0% obesity. MP indicated that 99.1% underestimated their child's nutritional status (Kappa = 0.022 and p= 0.610). After intervention, MP improved to 59.6% and 40.3% continued to underestimating child's nutritional status (kappa= 0.362 and p= 0.000). In this study, mothers tended to underestimate the nutritional status of their children. An educational intervention improved MP and the agreement between MP and child's nutritional status.

Evaluación de la percepción materna del peso del hijo y de la heredabilidad del IMC en diadas mestizas del Sureste de México

Estudio descriptivo correlacional. Los objetivos fueron: 1) evaluar la percepción materna del peso del hijo mediante dos pruebas percepción por palabras (PP) e índice de masa corporal del hijo percibido por la madre (IMCP), 2) Evaluar sensibilidad y especificidad de las pruebas y 3) Cuantificar la heredabilidad (h2) del índice de masa corporal (IMC) en 173 diadas (madre-hijo). La PP fue valorada por la pregunta ¿cómo cree que su hijo esta? Para valorar el IMCP, la madre refirió peso y talla del hijo y se calculó el IMC del hijo percibido por la madre. Se midió peso y talla a madres e hijos. Se encontró que 10.3% de madres de hijos con sobrepeso (SP) y 1.8% de madres de hijos con obesidad (OB) los percibieron de forma adecuada por la prueba (PP) y por la prueba IMCP el 38.5% y 67.3% de madres de hijos con SP y OB respectivamente. La sensibilidad de PP fue 5.3% y especificidad 29.1%. La sensibilidad de IMCP fue 55.3% y especificidad 54.4%. La h2 del IMC fue de 15%. Se concluye que las madres no perciben el SP-OB de sus hijos y que el cuestionar a la madre peso y talla del hijo (IMCP) podría ayudar a percibir el SP-OB del hijo. La h2 del IMC indica que los factores del estilo de vida en esta población contribuyen al SP-OB. Dada la amplia diversidad socio-económica y cultural, estos resultados de Campeche deberán de ser validados con diseños similares de estudio.

Descriptive correlational study. The objectives were the following: 1) evaluate maternal perception of her child’s weight through two test, Word-perception (WP) test and the Body mass index (BMI) of the child as perceived by the mother (Body weight index perception [BWIP]); 2) evaluate the sensitivity and specificity of the tests, and 3) quantify BMI heritability (h2) in 173 mother-child dyads. WP was assessed by asking the question, How do you think your child is? For assessing BWIP, the mother referred the child’s weight and height, and we calculated the child’s BMI as perceived by the mother. The weight and height of the mothers and their children were measured. We found that 10.3% of mothers of children with Overweight (OW) and 1.8% of mothers of children with Obesity (OB) perceived their children adequately by means of WP; by means of the BWIP test, 38.5 and 67.3% of mothers of children with OW and OB, respectively, exhibited adequate perception. BWIP sensitivity was 55.3% and specificity was 54.4%. BWI h2 was 15%. We was concluded that mothers did not perceive the OW-OB of their children, and that asking the mother for the weight and height of the child (BMIP) will aids her to perceive the OW-OB of her child. The BWI h2 indicate that the lifestyle factors of this population contribute to OW-OB. Given the broad socioeconomic and cultural diversity, these results of the southeastern Mexican state of Campeche should be evaluated with similar study designs.

"Quando eles crescem, eles voam": percepções e sentimentos maternos frente ao desenvolvimento infantil aos 18 - 20 meses / "Cuándo los niños crecen, los niños vuelan": percepciones maternales y los sentimientos delante de las adquisiciones del desarrollo a los 18 - 20 meses / \"When they grow, they fly\": perceptions and maternal feelings against the child development at 18 - 20 months

O presente estudo visou investigar as percepções e sentimentos maternos diante das aquisições de desenvolvimento da criança dos 18 aos 20 meses. Participaram 14 mães primíparas, com idades entre 20 e 37 anos, de níveis socioeconômicos variados, residentes com o marido na região metropolitana de Porto Alegre. Foi realizada e submetida à análise qualitativa de conteúdo uma entrevista semiestruturada que abordava a experiência da maternidade e o desenvolvimento da criança. Buscou-se examinar semelhanças e particularidades das percepções e sentimentos maternos ante as aquisições de desenvolvimento infantil. Os resultados revelaram um incremento nas aquisições de linguagem, motoras, socioemocionais e intelectual-cognitivas. As crianças demandaram maior atenção e disponibilidade materna, acarretando nas mães sentimentos positivos, negativos e ambivalentes. É importante que a mãe compreenda as aquisições próprias desse período, pois isso contribuirá para que ela lide mais adequadamente com uma relação que oscila entre dependência e independência.

The present study aimed to investigate maternal perceptions and feelings concerning child's developmental acquisitions from 18 to 20 months. Fourteen primiparus mothers, aged 20 to 37, of different socioeconomic background took part in the study. They lived with their partners in the metropolitan region of orto Alegre. A semi-structured interview was carried out, which was analyzed according to content analysis. The analysis focused on maternal experience and child development. The similarities and particularities of maternal perception and feelings concerning developmental acquisitions were examined. Results revealed an increase in language, motor, socio-emotional and cognitive-intellectual acquisitions. Children demanded more maternal attention and availability, provoking positive, negative and ambivalent feelings from their mother. It is important that mothers understand the acquisitions from this period which will enable them to deal more adequately with a relationship that oscillates between dependence and independence.

Este estudio tuvo como objetivo investigar las percepciones maternales y los sentimientos delante de las adquisiciones del desarrollo del niño de los 18 a los 20 meses. Participaron 14 madres primíparas, con edades entre 20 y 37 años, con nivel socioeconómico variado y que conviven con sus respectivos maridos en la región metropolitana de Porto Alegre. Fue realizada una entrevista semi-estructurada, submetida al análisis cualitativo del contenido, que abordó la experiencia de la maternidad y el desarrollo del niño. Se buscó examinar semejanzas y particularidades de las opiniones y sentimientos maternales frente a las adquisiciones del desarrollo infantil. Los resultados indicaron adquisiciones intensas de la lengua, de la motricidad, socio-emocionales y intelectuales-cognitivas. Los niños exigieron mayor atención y disponibilidad de las madres, causando sensaciones positivas, negativas y ambivalentes en las mismas. Es importante que la madre entienda las adquisiciones apropiadas de este período ya que contribuirá para un trato más adecuado en una relación que oscila entre la dependencia y la independencia del niño.

Factors Influencing Parenting Stress in Primiparas / 아동간호학회지

PURPOSE: The purpose of this study was to identify the factors influencing parenting stress in primiparas. METHOD: The participants in this study were 198 primiparas of infants aged 1-6 months who visited well baby clinics in 5 hospitals. The data were collected from April 15 to June 15, 2003. RESULTS: The mean score for parenting stress was 2.4 of a possible 5 and thus considered average. The score for parenting stress was significantly correlated with the level of maternal perception of the infant and the level of social support. The score for parenting stress was significantly different according to the education level of the primiparas and prenatal management. For the primiparas, social support(20%) and maternal perception of the infant(9%) were significant predictors explaining parenting stress. CONCLUSIONS: Nursing interventions to improve maternal perception of the infant and increase social support should be provided for primiparas in order to reduce parenting stress.

Relationship of Maternal Perception of the Infant Temperament and Confidence and Satisfaction of Maternal Role / 아동간호학회지

PURPOSE: this study was intended to search the relationship between perception of the infant temperament in mother of infant at the age of 1~12 months and maternal confidence and satisfaction in performing maternal role, and to submit a basic data to establish a nursing intervention program which is helpful for determination of infant development and performing maternal role promotion by identify variables associated with infant temperament. METHOD: The subjects of this study were 300 mothers of infant at the age of 1~12 months who visited well baby clinic in 4 hospitals in Busan city and Kyoung-Nam province. Final analysis was performed in 293 cases. Seven cases was excluded in this study because of its inappropriate data collection. The data was collected from 1st July to 15th August 2002. The questionaries which were fill-up by mother were collected. Infant temperament was measured by using the tool of "what my baby is like"(WBL) which was developed by Priham et. al.(1994) and translated by Bang(1999). The scale of postpartum self evaluation which was developed by Lederman et al(1981) and translated by Lee(1992) was used for the confidence and satisfaction of maternal role. All statistical analyses were performed using SPSS-PC for window, version 10.0: frequency, percentage, minimum, maximum, mean, SD, t-test, ANOVA, Post-hoc test(Scheffe's test), Pearson Correlation Coefficients. RESULT: The mean score of maternal perception of the infant temperament was 6.17 +/-1.04, and mother recognized her infant as positive. The mean score of confidence of maternal role was 2.89+/-.41 and this revealed in an average level. The mean score of satisfaction of maternal role was 3.29+/-.51 and this revealed in a higher level. There was a weak significant positive correlation between the score of maternal perception of infant temperament and confidence of maternal role(r=0.176, P= .003), but there was no significant correlation between satisfaction of maternal role(P > .05). It revealed the more maternal perception of the infant temperament as positive, the higher confidence of maternal role. There was a moderate significant positive correlation between confidence of maternal role and satisfaction of maternal role(r=0.410, P= .000). It revealed the more confidence of maternal role, the higher satisfaction of maternal role. The variables related with the score of maternal perception of infant temperament were the type of delivery (t=-2.600, P= .010), experience of learning baby care(t=2.382, P= .018), maternal perception on baby's health status(F=3.467, P= .033), maternal perception on her health status(F=3.467, P= .027), baby's age(F=3.080, P= .028). CONCLUSION: Our result showed the confidence of maternal role was increased as the maternal perception of infant temperament was positive, and conformed that the confidence of maternal role was also related with satisfaction of maternal role. Prenatal education, type of delivery, baby's age were also related with the maternal perception of infant temperament. So, nursing intervention program of developmental stage maybe necessary in order to help maternal perception of infant temperament as positive, and it will be increased the confidence of maternal role and satisfaction of performing maternal role which was considered as real indicate of achievement of maternal role.