Iran Journal of Nursing

Introduction
Hospitalization in the neonatal intensive care unit (NICU) causes loss or delay in maternal-fetal attachment. On the other hand, quarantine and social distancing during the COVID-19 pandemic had psychological consequences, including an increased fear of infection. This study aims to determine the relationship between mother-infant attachment behaviors and fear of COVID-19 in mothers with neonates admitted to the NICUs of selected hospitals in Tehran, Iran during the COVID-19 pandemic.

Methods
In this descriptive-correlational study, 195 mothers with neonates admitted to the NICUs of selected teaching hospitals affiliated to Iran University of Medical Sciences in 2021 were selected. Data collection tools were a demographic form, the fear of COVID-19 scale (FCoV-19S), and Avant’s questionnaire of mother-infant attachment behaviors, which were completed by the researcher. Data were analyzed in SPSS software, version 16 using independent t-test, Kruskal-Wallis test, Mann-Whitney U test, and ANOVA.

Results
Most of the mothers (89.7%) were housewives and had a high school diploma (37%), The most common cause of hospitalization was related to infant jaundice (32.3%). The mean score of FCoV-19S was 19.04±5.40, indicating a moderate level of fear. Also, the mean score of mother-infant attachment was 52.31±12.57, indicating a low degree of attachment. No significant relationship was observed between the fear of COVID-19 and mother-infant attachment (P>0.05).

Conclusions
Mother-infant attachment of mothers in this study is low, and their fear of COVID-19 was almost high. There is no significant correlation between the fear of COVID-19 and mother-infant attachment behaviors. It is necessary to pay attention to effective factors in promoting emotional attachment between mothers and neonates hospitalized in the NICUs. It is also recommended that the medical staff and nurses pay attention to this group of mothers during pandemics such as COVID-19 and use some techniques to reduce their fear of infection.

Ethical Considerations
Compliance with ethical guidelines
The objectives of the study were explained to the participants and they were assured of the confidentiality of their information. A written informed consent was obtained from them. This study was approved by the Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1400.227).

Funding
This article was extracted from the master’s thesis of Maryam Baradari, approved by the Department of Pediatric and Neonatal Intensive Care Nursing, Nursing and Midwifery School. The study was funded by Iran University of Medical Sciences.

Authors' contributions
Sampling, data analysis, and initial draft preparation: Maryam Baradari; Conceptualization, supervision, editing & review:Mahnaz Shoghi.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank the Deputy for Research and Technology of Iran University of Medical Sciences, the clinical research development units and the NICU staff of Shahid Akbarabadi, Hazrate Ali Asghar, and Rasule Akram hospitals and the mothers participated in this study for their support and cooperation.

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