JMIR Publications

ABSTRACT

ABSTRACT Introduction In China, the postpartum exhaustion rate has been on the rise to around 76.13% in the first week postpartum. Experiencing fatigue is common after just about any surgery, whether it be taking a choke hold or a simple knee arthroscopy done as day surgery. This is not the same as feeling tired. This fatigue is a complicated symptom that arises from the mix of physical recovery, mental adjustment, and the demands of caring for a baby. It is worth noting here that the stress experienced by the mothers in such instances can have adverse effects on both the physical and mental state of the mothers. Furthermore, it may interfere with mother-infant interactions. Consequently, such stress on the mothers may also interrupt the emotional, cognitive and regulatory developments of the infants. Although frequent, nothing has been recommended for these mothers. Thus, this research aims to devise a suitable protocol to help reduce the impact of maternal postpartum fatigue on the emotional development of children. Methods and analysis The study will consist of 412 women with postpartum fatigue within the first week of delivery. Participants will be classified on the basis of their fatigue (mild, moderate, severe) and fatigue aspects (physical, mental). At the three-month follow-up of the newborn, the infant’s emotional development will be assessed in respect of his emotional expression, emotional regulation and emotional recognition. The assessment process will occur through some steps. Primarily, Spearman’s correlation coefficient will assess the association between postpartum fatigue and infant emotional development results. Subsequently, a Restricted Cubic Spline (RCS) model will be applied to examine any potential non-linear associations. In this approach, postpartum fatigue scores are going to act as continuous independent variables, while the indicators of infant emotional development are going to be treated as dependent variables. After adjusting for important covariates, a RCS will be fitted to the data to form the curve of the non-linear association, and a likelihood ratio test will be used to test for non-linearity. The results will be demonstrated to identify possible thresholds, inflection points, or trends in the curve. Further, multiple linear regression will be conducted to examine the relationship between postpartum fatigue and infant emotional development controlling for other factors. Finally, the underlying mechanisms will be developed in a Structural Equation Model (SEM) using AMOS software. We will use the Bootstrap method to test the significance of a chain mediation effect, where oxytocin levels and maternal behaviours mediate the effect of maternal fatigue on infants’ emotional development in a sequence. Ethics and dissemination This study was approved by the Ethics Committee of Nantong University (Approval No.: Tongda Lunshen (2025) 70; Date of approval: March 3, 2025). All study procedures were performed in accordance with the principles of medical ethics.