Maternal–Infant interaction in women with unipoloar and bipolar depression

Logsdon, M. Cynthia; Mittelberg, Meghan; Jacob, Alexandra; Luther, James F.; Wisniewski, Stephen R.; Confer, Andrea L.; Eng, Heather; Wisner, Katherine L.

doi:10.1016/j.apnr.2015.01.012

Cited by 13 publications

(18 citation statements)

References 11 publications

(12 reference statements)

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“…One paper published after the systematic review was finished [51] showed that women with BD had lower scores on maternal-infant interaction at 12 months postpartum; this is an area that would benefit from further study. Marengo et al [52], also published after the systematic review was finished, highlighted results related to reproduction decisions of women with BD.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty-eight papers were found in PubMed in this second search and no papers in the Cochrane Library. Four new papers [51–54] were found to be topical for this review. Logsdon et al 2015 [51] described maternal-infant interaction at 12 months postpartum in women with BD compared to women with unipolar depression and a control group without a major mood disorder.…”

Section: Methodsmentioning

confidence: 99%

“…Four new papers [51–54] were found to be topical for this review. Logsdon et al 2015 [51] described maternal-infant interaction at 12 months postpartum in women with BD compared to women with unipolar depression and a control group without a major mood disorder. Marengo et al 2015 [52] looked at how women with BD made reproductive decisions.…”

Section: Methodsmentioning

confidence: 99%

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Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Rusner

Berg

Begley

2016

BMC Pregnancy Childbirth

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BackgroundBipolar Disorder (BD) is a mental disorder usually diagnosed between 18 and 30 years of age; this coincides with the period when many women experience pregnancy and childbirth. As specific problems have been reported in pregnancy and childbirth when the mother has BD, a systematic review was carried out to summarise the outcomes of pregnancy and childbirth, in mother and child, when the mother has BD diagnosed before pregnancy.MethodsAn a priori protocol was designed and a systematic search conducted in PubMed, CINAHL, Scopus, PsycINFO and Cochrane databases in March 2015. Studies of all designs were included if they involved women with a diagnosis of bipolar disorder prior to pregnancy, who were pregnant and/or followed up to one year postpartum. All stages of inclusion, quality assessment and data extraction were done by two people. All maternal or infant outcomes were examined, and narrative synthesis was used for most outcomes. Meta-analysis was used to achieve a combined prevalence for some outcomes and, where possible, case and control groups were combined and compared.ResultsThe search identified 2809 papers. After screening and quality assessement (using the EPHPP and AMSTAR tools), nine papers were included. Adverse pregnancy outcomes such as gestational hypertension and antepartum haemorrhage occur more frequently in women with BD. They also have increased rates of induction of labour and caesarean section, and have an increased risk of mood disorders in the postnatal period. Women with BD are more likely to have babies that are severely small for gestational age (<2nd-3rd percentile), and it appears that those women not being treated with mood stabilisers in pregnancy might not have an increased risk of having a baby with congenital abnormalities.DiscussionDue to heterogeneity of data, particularly the use of differing definitions of bipolar disorder, narrative synthesis was used for most outcomes, rather than a meta-analysis.ConclusionsIt is evident that adverse outcomes are more common in women with BD and their babies. Large cohort studies examining fetal abnormality outcomes for women with BD who are not on mood stabilisers in pregnancy are required, as are studies on maternal-infant interaction.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1127-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Rusner

Berg

Begley

2016

BMC Pregnancy Childbirth

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“…Within the first year, impairments in maternal behaviour, such as reduced sensitivity, have been demonstrated among mothers with BD (Hipwell et al 2000 ; Hipwell and Kumar 1996 ). Studies have also reported non-significant trends of decreased infant expressivity (Hipwell et al 2000 ) and dyadic reciprocity (Logsdon et al 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Bipolar offspring and mothers: interactional challenges at infant age 3 and 12 months—a developmental pathway to enhanced risk?

Anke

Slinning

Moe

et al. 2020

Int J Bipolar Disord

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Background: Bipolar offspring are considered a high-risk group for developing mental disorders. Developmental outcomes result from additive and interactive effects of biological vulnerability and environmental influences. Mother-infant interactions represent important early environmental influences that may modify infants' risk of mental disorders. The aim of the current prospective study was to investigate the patterns and development of motherinfant interactions in the first year of life in dyads in which the mothers have bipolar disorder (BD). Methods: Twenty-six dyads in which the mothers had BD and 28 dyads in which the mothers had no mental disorder were video-taped in a free play interaction. The Parent-Child Early Relational Assessment (PCERA) was used to assess the quality of the interactions on three domains (maternal behaviour, infant behaviour and dyadic coordination) at 3 and 12 months of infant age. First, we compared the mother-infant interaction patterns between the two groups at 12 months. Second, we investigated how the patterns developed within and between the groups from infant ages 3 to 12 months. Results: BD dyads demonstrated significantly more challenges in all three interaction domains at infant age 12 months compared to the healthy dyads. This observation was in line with the findings at infant age 3 months. Subdued expression of positive affect and mutual underinvolvement represented core challenges in maternal and infant behaviours in the BD dyads. Continuous difficulties with dyadic coordination and reciprocity were the most concerning interaction behaviours at 3 and 12 months. On the positive side, there was little expression of negative affect or tension in maternal, infant and dyadic behaviour, and some positive changes in infant behaviour from 3 to 12 months. Conclusions: The current results suggest that challenges in mother-infant interaction patterns in the first year of life may enhance the developmental risk for bipolar offspring. Clinical interventions should address both the BD mothers' needs in relation to postpartum mood deviations and mother-infant interactions. We suggest interaction interventions to promote dyadic coordination and reciprocity, such as helping mothers being more sensitive to their infant's cues and to provide attuned contingent responses.

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“…While many mothers with bipolar disorder would like to breastfeed, most mothers with postpartum psychosis or bipolar disorder require treatment with psychotrophic medications, especially antipsychotics and mood stabilizers. In addition, maternal psychiatric disturbances during the postpartum period negatively influence not only mothers but also mother−infant relationships and child−mother attachment, and can lead to suicidal and infanticidal behaviors, especially if there are psychotic features . On the other hand, the benefits of breastfeeding should be carefully balanced against the deleterious effect of sleep deprivation in triggering mood episodes .…”

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confidence: 99%

Mood stabilizers during breastfeeding: a systematic review of the recent literature

Uğuz

Sharma

2016

Bipolar Disorders

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The current data suggest that mood stabilizers can be prescribed without any adverse events in most infants in lactating women. The available reports also suggest a low prevalence rate of laboratory abnormalities including hepatic, kidney, and thyroid functions in the infants. Additional studies examining short-term and especially long-term effects of mood stabilizers on breastfed infants are required.

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Maternal–Infant interaction in women with unipoloar and bipolar depression

Cited by 13 publications

References 11 publications

Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes

Bipolar offspring and mothers: interactional challenges at infant age 3 and 12 months—a developmental pathway to enhanced risk?

Mood stabilizers during breastfeeding: a systematic review of the recent literature

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