The impact of postpartum depression and bonding impairment on child development at 12 to 15 months after delivery

Abstract

• This study provides findings on postpartum depression and bonding impairment among a low-income sample. • The prevalence of child developmental delay among low-income women with depression is high. • Not all women who report depression also report bonding impairment. • Bonding impairment is significantly associated with later child developmental delay after controlling for antenatal and postnatal depression. Background: We evaluated the association between mother-child bonding and maternal depression at 6–8 months after birth, isolated and conjoined, with child developmental delay (CDD) at 12–15 months in a sample of vulnerable mothers. Methods: A prospective cohort study with 358 low-income postpartum women with antenatal depression. All participants were enrolled in a cluster-randomized trial to evaluate the impact of a depression management program. The Postpartum Bonding Questionnaire and the Patient Health Questionnaire were used at 6–8 months postpartum to assess mother-infant bonding impairment (BI) and postpartum depression (PPD). The Denver Developmental Screening Test was used at 12–15 months after delivery to assess the child's neurodevelopment. Crude and adjusted odds ratios (ORs) were estimated using logistic regression. Results: Among 216 participants who received the CDD evaluation at 12–15 months, 158 (73.1%) had no symptoms of PPD or BI, while 11 (5.1%) had PPD and BI at the same time. CDD was observed in 15.3% (95% CI 10.4:20.1). CDD was associated with BI (OR:1.07; 95% CI 1.02:1.13), non-White skin color (OR: 3.40; 95% CI 1.10:10.39), masculine gender of the baby (OR: 4.71; 95% CI 1.66:13.37), and premature delivery or low birth weight (OR: 4.99; 95% CI 1.74:14.29). Conclusions: BI, but not PPD, at 6–8 months, is associated with CDD at 12–15 months. The assessment of BI, a modifiable risk factor for child development, should be included as part of proper maternal mental health care.