Peripartum depression: Does risk versus diagnostic status impact mother-infant bonding and perceived social support?

Depress Anxiety. 2021 Apr;38(4):390-399. doi: 10.1002/da.23121. Epub 2020 Dec 7.

Abstract

Background: Peripartum depression (PND) impairs mother-infant boding and perceived social support, yet limited research has examined if women at-risk for PND (AR-PND) also experience impairment. We examined if pregnant women AR-PND, women with PND, and healthy comparison women (HCW) differed in their mother-infant bonding and social support. As PND is highly comorbid with anxiety, we also examined if peripartum anxiety impacted postpartum diagnosis of PND.

Methods: A total of 144 pregnant women AR-PND or euthymic were assessed twice antepartum and twice postpartum. We utilized regression models to examine the impact of PND risk group status and diagnostic status on mother-infant bonding and perceived social support postpartum. We conducted a sensitivity analysis using a generalized estimating equations model to determine if anxiety (Hamilton Anxiety Rating Scale, HAM-A) across all four time points was associated with the postpartum diagnosis of PND.

Results: Women AR-PND experienced significantly worse mother-infant bonding compared to HCW (p = .03). Women diagnosed with PND experienced significantly worse mother-infant bonding and social support compared to HCW (p = .001, p = .002, respectively) and to those who were at-risk for but did not develop PND (p = .02, p = .008, respectively). HAM-A severity at each visit was associated with PND diagnosis status, where each increase in HAM-A was associated with 15% increased odds of being diagnosed with PND postpartum.

Conclusions: Both women AR-PND and those with PND experience worse mother-infant bonding. Peripartum anxiety should also be assessed as it represents a marker for later PND.

Keywords: anxiety; depression; mother-infant relationship; peripartum; postpartum; social support.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Depression
  • Depression, Postpartum* / diagnosis
  • Depression, Postpartum* / epidemiology
  • Female
  • Humans
  • Infant
  • Mother-Child Relations
  • Mothers*
  • Object Attachment
  • Peripartum Period
  • Postpartum Period
  • Pregnancy
  • Social Support