The association of maternal postpartum depression with infant weight growth: a prospective birth cohort study

Background Untreated maternal postpartum depression has consequences for infant weight, which may vary with infant growth time and postpartum depression duration. Dynamic assessment of the association between maternal postpartum depression and infant weight growth is crucial for early detection of the suspicious abnormal effects of maternal postpartum depression on infant weight growth and taking corresponding intervention measures. But, none of published studies continuously and dynamically evaluated these effect changes on infant weight growth. This study was aimed to evaluate the dynamic effects of maternal postpartum depression on infant weight growth at a prospective birth cohort. Methods 960 mother-infant pairs between 2015 to 2018 in Changsha, China were followed up at ages of 1, 3, 6, 8, and 12 months. Data were obtained through household surveys. Depression of mothers was assessed at 1 month postpartum. Linear mixed models and generalized estimating equation models were used to test the connection and its changes between maternal postpartum depression and infant weight growth at five different periods of 1–12 months. Results 8.0% of mothers reported postpartum depression. Adjusted linear mixed models showed a negative association between maternal depression at 1-month postpartum and infant weight at 1 month, 1–3 months, 1–6 months, 1–8 months, and 1–12 months, in which infants with depressed mothers were the lighter weight of 0.14kg (95%CI:0.02, 0.25), 0.13kg (95%CI:0.02, 0.24), 0.13kg (95%CI:0.02, 0.24), 0.13kg (95%CI:0.02, 0.24), and 0.16kg (95%CI:0.04, 0.27) relative to not depressed respectively. Generalized estimating equation models showed a positive association between maternal depression at 1-month postpartum and infant underweight at 1 month and 1–3 months, in which infants of maternal depression had higher risk ratio of underweight in 3.19 (95%CI:1.38, 7.34) and 3.19(95%CI:1.32, 7.70) compared to those mothers were not depressed accordingly. Conclusions Maternal postpartum depression was continuously associated with a lighter weight of ifants from 1 to 12 months and higher risk of being underweight in infants from 1 to 3 months. It seems important to put early prevention, screening, diagnosis, and treatment of maternal depression into practice as soon as possible to avoid adverse consequences.

A Maternal Postpartum Depression Consequences towards Mother-child interaction Outcomes: A systematic review

Postpartum depression is a psychiatric disorder that starts from the second to the sixth week after birth. Postpartum depression has been shown to have an association with infant growth, nutrition, bonding, temperament and ultimately childhood mental wellbeing. This paper reviews overall outcomes of untreated maternal postpartum depression towards the mother-child interactions consequences. Systematic review was conducted in the online databases Google Scholar and PubMed using the index terms “postpartum depression” and “maternal outcomes” or “children outcomes”. Total of 10 studies (out of 112 references retrieved from bibliographic databases) were included in this systematic review. The results of the studies were synthetized into mother–child interactions, including bonding, breastfeeding, and the maternal role. The results suggest that postpartum depression creates an environment that is not conducive to the mother-child interaction thus regressing personal development of mothers or the optimal development of a child. It therefore seems important to detect and treat depression during the postnatal period as early as possible to avoid harmful consequences.

Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology

Parental reflective functioning (PRF) refers to the parent’s capacity to envision mental states in the infant and in themselves as a parent, and to link such underlying mental process with behavior, which is important for parenting sensitivity and child socio-emotional development. Current findings have linked maternal postpartum depression to impaired reflective skills, imposing a risk on the developing mother–infant relationship, but findings are mixed, and studies have generally used extensive methods for investigating PRF. The present study examined the factor structure and measurement invariance of the Danish version of the 18-item self-report Parental Reflective Functioning Questionnaire (PRFQ) in a sample of mothers with and without diagnosed postpartum depression. Moreover, the association between PRF and maternal postpartum depression in mothers with and without comorbid symptoms of personality disorder and/or clinical levels of psychological distress was investigated. Participants included 423 mothers of infants aged 1–11 months. Confirmatory factor analysis supported a three-factor structure of the PRFQ; however, item loadings suggested that a 15-item version was a more accurate measure of PRF in mothers of infants. Multi-group factor analysis of the 15-item PRFQ infant version indicated measurement invariance among mothers with and without diagnosed postpartum depression. Multinomial logistic regression showed that impaired PRF was associated with maternal psychopathology, although only for mothers with postpartum depression combined with other symptoms of psychopathology. These results provide new evidence for the assessment of maternal self-reported reflective skills as measured by a modified infant version of the PRFQ, as well as a more nuanced understanding of how variance in symptomatology is associated with impaired PRF in mothers in the postpartum period in differing ways.

The role of intimate partner violence victimization during pregnancy on maternal postpartum depression in Eastern Ethiopia

Background: Intimate partner violence during pregnancy is a strong predictor of maternal postpartum depression. In Ethiopia, evidence on the association of intimate partner violence during pregnancy with postpartum depression is very limited. To design appropriate intervention, it is thus important to understand how postpartum depression varies as a function of the type and severity of intimate partner violence victimization during pregnancy. The aim of this study is to explore the association of different types of intimate partner violence during pregnancy and its severity with postpartum depression in Eastern Ethiopia. Method: A community-based cross-sectional study was conducted from January to October 2018. The study included a sample of 3015 postpartum women residing in Eastern Ethiopia. The cutoff point for postpartum depression was defined as ⩾13 points according to the Edinburgh Postnatal Depression Scale. The prevalence ratio with 95% confidence intervals was calculated, and the association between the main predictor (i.e. intimate partner violence during pregnancy) and the outcome variable (postpartum depression) was determined using log binomial regression model. Results: 16.3% (95% confidence interval: 14.9–17.7) of women experienced postpartum depression. After controlling potential confounding factors, the prevalence of postpartum depression among women exposed to severe physical intimate partner violence during pregnancy was 1.98 times higher as compared to those not exposed to physical intimate partner violence during pregnancy (adjusted prevalence ratio = 1.98; 95% confidence interval: 1.53–2.54). Exposure to psychological intimate partner violence during pregnancy was found to increase the prevalence of postpartum depression by 1.79 as compared to non-exposure to psychological intimate partner violence during pregnancy (adjusted prevalence ratio = 1.79; 95% confidence interval: 1.48–2.18). Conclusion: The study provides evidence that psychological and severe physical intimate partner violence during pregnancy were significantly associated with maternal postpartum depression. Screening of pregnant women for intimate partner violence and providing them the necessary support can minimize the risk to postpartum depression.