Mother-to-Infant Bonding in Women with Postpartum Psychosis and Severe Postpartum Depression: A Clinical Cohort Study

Abstract

Mother-to-infant bonding is important for long-term child development. The aim of this study was to investigate bonding in women admitted to a Mother and Baby Unit with postpartum depression (PD, n = 64) and postpartum psychosis (PP, n = 91). Participants completed the Postpartum Bonding Questionnaire (PBQ), the Edinburgh Postnatal Depression Scale (EPDS) and the Young Mania Rating Scale (YMRS) weekly during admission. At admission, 57.1% of women with PD had impaired bonding, compared to only 17.6% of women with PP (p-value < 0.001). At discharge, only 18.2% of women with PD and 5.9% of women with PP still experienced impaired bonding (p-value = 0.02). There was a strong association between decrease of depressive and manic symptoms and improved bonding over an eight-week admission period. In a small group of women (5.7%) impaired bonding persisted despite being in remission of their psychiatric disorder. The results from our study show that impaired bonding is a more present and evidently severe problem in postpartum depression but not so much in postpartum psychosis. Treatment of depressive symptoms will improve bonding in almost all women, but clinicians should assess if impaired bonding is still present after remission because for a small group special care and treatment focused on bonding might be required.

Relationship of premenstrual syndrome with postpartum depression and mother–infant bonding

“…Delavari et al 10 found that maternal–fetal attachment is one of the factors contributing to postpartum depression. Mother‐to‐baby attachment is thought to form the foundation for the child's later attachment 11 . The negative mother–infant relationship that occurs in the first years of the baby's life has long‐term negative consequences in emotional, social, and cognitive terms.…”

“…Mother-to-baby attachment is thought to form the foundation for the child's later attachment. 11 The negative mother-infant relationship that occurs in the first years of the baby's life has longterm negative consequences in emotional, social, and cognitive terms. Therefore, the development of mother-baby bond is important.…”

“…Therefore, the development of mother-baby bond is important. 9,11 Kasamatsu et al 12 found that in a large-scale cohort in Japan, postpartum depression may be a strong predictor of mother-infant attachment failure first year after birth. In a cohort study conducted by Fuchs et al 13 determined relationship between impaired mother-infant bonds and child behavioral problems in early childhood.…”

Research on Women's Health: Ready for the Future

“…In contrast, PPD—experienced by about 13% of women with a recent live birth in the United States in 2018 32 —is an intense persistent sadness that can interfere with a woman's ability to care for herself and the baby, 33 last for up to 3 years in some women, 34 and elevate depressive symptoms up to 11 years after childbirth. 35 Worryingly, the rate of women with a depression diagnosis at delivery increased sevenfold between 2000 and 2015.…”

Translation and Validation of the Birth Satisfaction Scale-Revised in Urdu for Use in Pakistan

“…With reducing associated factors within the birthing environment critical for optimising clinical outcomes (International Consortium for Health Outcome Measurement, 2016). In addition, there is compelling evidence that links maternal well-being to that of the infant (Bang et al, 2020;Gilden et al, 2020;Sliwerski, Kossakowska, Jarecka, Switalska, & Bielawska-Batorowicz, 2020). Thus, appreciating women's birth experiences is crucial towards improving relationships with staff, the clinical environment, care provided, experiences of interventions, and understandings of their associations with outcomes (Alfaro Blazquez, Corchon, & Ferrer Ferrandiz, 2017;Nijagal et al, 2018;Nilver, Begley, & Berg, 2017).…”