Maternal Postpartum Depression Research Articles

Comparing maternal factors associated with postpartum depression between primiparous adolescents and adults: Alarge retrospective cohort study.

This study aimed to estimate the prevalence of diagnosed postpartum depression (PPD) and the likelihood of PPD among primiparous women. We also evaluated differences in the influence of various maternal factors associated with PPD in adolescent versus adult mothers. We conducted a retrospective cohort study using electronic health records linked to birth certificates to evaluate the associations between maternal factors and PPD diagnosis. The study population was stratified into adults and adolescents based on age at delivery. We evaluated socioeconomic, demographic, psychological, and clinical factors associated with PPD in each of the age-defined maternal cohorts using multivariable logistic regression analyses. A total of 61,226 primiparous women, including 6435 (11%) mothers younger than 20 years old, were included in the study. The overall PPD rate was 4.0%, with the age-specific PPD rate measuring 1.6 times higher in adolescents than in adult women (6.1% vs. 3.8%). Compared with adults, adolescents were less likely to obtain firsttrimester prenatal care (33% vs. 16%), more likely to have recent tobacco use (11% vs. 6%), and more likely to have had an infection during pregnancy (5% vs. 1%). In adjusted models, significant factors for PPD in both groups included a history of depression or anxiety, tobacco use, and long-acting reversible contraception use. In this cohort of first-time mothers, adolescents had higher rates of PPD diagnosis as well as PPD-associated maternal factors than adults. Increased awareness of PPD risk in adolescents and early intervention, including integrating mental healthcare into prenatal care, may help benefit adolescents and reduce the risk and severity of PPD.

Association of Antepartum and Postpartum Air Pollution Exposure With Postpartum Depression in Southern California

Women are especially vulnerable to mental health matters post partum because of biological, emotional, and social changes during this period. However, epidemiologic evidence of an association between air pollution exposure and postpartum depression (PPD) is limited. To examine the associations between antepartum and postpartum maternal air pollution exposure and PPD. This retrospective cohort study used data from Kaiser Permanente Southern California (KPSC) electronic health records and included women who had singleton live births at KPSC facilities between January 1, 2008, and December 31, 2016. Data were analyzed between January 1 and May 10, 2023. Ambient air pollution exposures were assessed based on maternal residential addresses using monthly averages of particulate matter less than or equal to 2.5 μm (PM2.5), particulate matter less than or equal to 10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) from spatial interpolation of monitoring station measurements. Constituents of PM2.5 (sulfate, nitrate, ammonium, organic matter, and black carbon) were obtained from fine-resolution geoscience-derived models based on satellite, ground-based monitor, and chemical transport modeling data. Participants with an Edinburgh Postnatal Depression Scale score of 10 or higher during the 6 months after giving birth were referred to a clinical interview for further assessment and diagnosis. Ascertainment of PPD was defined using a combination of diagnostic codes and prescription medications. The study included 340 679 participants (mean [SD] age, 30.05 [5.81] years), with 25 674 having PPD (7.54%). Increased risks for PPD were observed to be associated with per-IQR increases in antepartum and postpartum exposures to O3 (adjusted odds ratio [AOR], 1.09; 95% CI, 1.06-1.12), PM10 (AOR, 1.02; 95% CI, 1.00-1.04), and PM2.5 (AOR, 1.02; 95% CI, 1. 00-1.03) but not with NO2; PPD risks were mainly associated with PM2.5 organic matter and black carbon. Overall, a higher risk of PPD was associated with O3 during the entire pregnancy and postpartum periods and with PM exposure during the late pregnancy and postpartum periods. The study findings suggest that long-term exposure to antepartum and postpartum air pollution was associated with higher PPD risks. Identifying the modifiable environmental risk factors and developing interventions are important public health issues to improve maternal mental health and alleviate the disease burden of PPD.

Maternal postpartum depression literacy subtypes: A latent profile analysis

AimTo explore the potential categories and characteristic differences of maternal postpartum depression literacy. DesignCross-sectional survey. MethodsFrom February 2023 to April 2023, convenience sampling was used to survey 278 women attending postnatal visits to three tertiary level A hospitals. The study included general demographic characteristics, postpartum depression literacy scale, and family caring index scale. Latent profile analysis was performed to identify the categories of maternal postpartum depression literacy, and multiple disordered logistic regression was used to analyze the influencing factors of different categories. ResultsMaternal postpartum depression literacy was divided into three categories: low literacy (41.0 %), moderate literacy (32.4 %), and high literacy (26.6 %). The results showed that work status, education level, whether the pregnancy was planned, whether or not they had participated in mental health-related courses, and family functioning status were factors influencing the category of maternal postpartum depression literacy (P < 0.05). ConclusionThere was heterogeneity in postpartum depression literacy among mothers. Medical staff should implement targeted interventions according to potential category characteristics and influencing factors to improve the level of postpartum depression literacy.

Depression and diet-related distress among Japanese women with gestational diabetes mellitus.

Although the association between gestational diabetes mellitus (GDM) and maternal postpartum depression has been reported, the association between these two factors during pregnancy has not been sufficiently examined. We compared pregnant women with and without GDM to clarify the association and examined factors related to depression in pregnant women with GDM. Questionnaires were administered longitudinally to pregnant Japanese women in the third trimester and at 2 and 4 weeks postpartum. One hundred and five and 108 pregnant women with and without GDM, respectively, were included in the study. Of the 105 women with GDM, 20 (19.0%) reported being depressed during pregnancy, which was significantly higher than that among those without GDM (9.3%). Binomial logistic regression analysis revealed that depression was significantly positively associated with diet-related distress and negatively associated with social support among women with GDM. Diet-related distress and social support are important factors in managing depression in pregnant women with GDM.

Effects of postnatal exposure to phthalate, bisphenol a, triclosan, parabens, and per- and poly-fluoroalkyl substances on maternal postpartum depression and infant neurodevelopment: a korean mother-infant pair cohort study.

Exposure to endocrine-disrupting chemicals (EDCs) can promote infant neurodevelopmental impairment and maternal postpartum depression (PPD). However, the associations between lactation exposure to EDCs, maternal PPD, and infant neurodevelopment are unclear. Hence, we investigated these relationships in infants aged 36-42months. We recruited 221 Korean mothers and analyzed 29 EDCs. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal PPD. Bayley scales of infant development; the Swanson, Nolan, and Pelham rating scale (SNAP); and the Child Behavior Checklist (CBCL) were used to assess neurodevelopment in infants exposed to the top 30% of EDC over three years. Multiple regression analyses were adjusted for maternal age, pre-pregnancy body mass index, education, income, employment, residence, and infant age and sex. The rates of infants with clinically abnormal diagnoses on neurologic developmental tests (Balyey, SNAP, and CBCL scales) ranged from 7.7 to 38.5% in this study, with the motor and hyperactivity/impulsivity areas scoring the highest among 65 boys and girls. Mono-2-ethylhexyl phthalate (MEHP) and mono-isononyl phthalate (MiNP) levels in breast milk significantly correlated with infant inattention and hyperactivity. Perfluorononanoic acid (PFNA) and perfluorooctyl sulfonate (PFOS) levels correlated significantly with motor development of BSID-III and total CBCL score which mean infant might have lower developmental status. EDC concentrations in breast milk were not associated with maternal PPD. Overall, lactational exposure to EDCs during the postpartum period can exert a negative effect on maternal PPD and infant neurodevelopment.

Risk for Developmental Delay Among Infants Born During the COVID-19 Pandemic.

Attempts by governments around the world to mitigate the spread of COVID-19 have substantially altered the early rearing environment, raising concerns about potential negative consequences for babies born during this time. The objective of this study was to determine whether infants born during the COVID-19 pandemic were at greater risk of screening positive for developmental delay compared with infants born before the pandemic. Participants were from 2 longitudinal cohorts. The prepandemic cohort, Impact of Maternal and Paternal Postpartum Depression, recruited postpartum individuals in the period between 2015 and 2018. Infant development milestone data (Ages and Stages Questionnaire [ASQ-3]) were collected at 1-year postpartum (n = 2903), between 2016 and 2019. The pandemic cohort, Pregnancy during the Pandemic, recruited pregnant individuals between April 2020 and April 2021. Infant development milestone data (ASQ-3) were collected at 1-year postpartum (n = 3742), between May 2021 and December 2022. Sociodemographic information, pregnancy outcomes, and depression symptom data were also collected. In covariate-adjusted analyses, pandemic-born infants had lower mean scores and higher odds of screening positive for delay on the Communication, Gross Motor, and Personal-Social domains of the ASQ-3 compared with prepandemic infants. Sex differences showed that males and females screened "at risk" in different domains. Most pandemic-born infants display typical development, and differences between prepandemic and pandemic-born infants were small. Nevertheless, an increased risk for delayed development among pandemic-born infants suggests the need for ongoing monitoring to determine what, if any, resources and interventions are needed to support healthy child development.

Association between maternal postpartum depression and children's physical growth in early childhood: a birth cohort study.

Untreated maternal postpartum depression (PPD) has consequences for children's physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort. Between 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers' depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months. A total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (β = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (β = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children. The number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken. After adjustments for confounders, no dynamic association was found between PPD and children's weight and height growth. EPDS scores, in contrast, did negatively affect children's weight and height growth at age 1-3 months, but this effect was not long-lasting.

Association between the continuum of care and postpartum depression among Angolan mothers

BackgroundThis study investigated the association between maternal and child health service utilization patterns and postpartum depression (PPD). MethodsThis study analyzed a dataset of women who participated in a randomized controlled trial to examine the effectiveness of the Maternal and Child Health Handbook in Angola. We defined probable PPD as an Edinburgh Postpartum Depression Scale (EPDS) score ≥ 10. The EPDS was administered at approximately 6 months postpartum. Service utilization patterns were defined using numbers of antenatal care (ANC), facility delivery, and vaccination visits by 6 months postpartum. The association between service utilization patterns and PPD was examined using logistic regression analyses adjusting for socioeconomic factors and parity. The continuum of care (CoC) complete pattern (four ANC/facility delivery/four vaccination) was used as a reference. ResultsThe data of 7087 participants whose children were alive and aged 6 months or older at the endline survey were analyzed. Prevalence of PPD was 17.9 % in urban and 43.2 % in rural municipalities. In urban municipalities, dropouts from the CoC at delivery and after delivery had significantly higher odds of PPD (AOR = 1.45, 95 % CI = 1.00–2.10; AOR = 1.57, 95 % CI = 1.24–1.99). In rural municipalities, dropouts from the CoC after delivery (AOR = 1.60, 95 % CI = 1.12–2.28) had significantly higher odds of PPD. LimitationsThe onset of depressive symptoms was not assessed. The EPDS was validated in some Portuguese speaking countries but not in Angola. ConclusionPPD was associated with irregular service utilization patterns such as dropouts from the CoC. Therefore, CoC and mental health must be promoted simultaneously.

Maternal Self-Efficacy, Body Dissatisfaction, and Postpartum Depression in Primiparous Indonesian Mothers

The global prevalence of postpartum depression (PPD) has increased over the past two decades. The vast changes in the social and physical body are two crucial postpartum stressors in first-time mothers that may evoke depressive symptoms. This study aims to determine whether there is a significant effect of maternal self-efficacy (MSE) and body dissatisfaction (BD) towards PPD in primiparous mothers. The survey involved approximately 245 Indonesian primiparous mothers within the postpartum period of 0-12 months. Data was disclosed through PMP S-E, BSQ-8B, and EPDS. Regression analysis showed PPD was simultaneously (R = 0,433; R2 = 0,188; p = 0,00) affected by MSE and BD by 18,8%. PPD was also partially affected by both variables, with BD contributing higher (β = 0,167; p = 0,00) than MSE (β = -0,172; p = 0,00). MSE and BD are predictors of PPD in Indonesian primiparous mothers.

Impact of trajectories of maternal postpartum depression on infants' socioemotional development.

We assessed (a) the effects of postpartum depression (PPD) trajectories until 6 months postpartum on infants' socioemotional development (SED) at age 12 months, and (b) the mediating role of maternal self-efficacy (MSE), and the additional effect of postpartum anxiety at age 12 months. We used data from POST-UP trial (n = 1843). PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 1, 3, and 6 months. Infants' SED was assessed at 12 months using the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE). Structural equations were applied to estimate the effect of PPD trajectories on infants' SED and mediation by MSE. The additional effects of postpartum anxiety were assessed with conditional regression. Higher levels of PPD over time were associated with a lower SED (coefficient for log-EPDS 3.5, 95% confidence interval 2.8; 4.2, e.g., an increase in the EPDS score from 9 to 13 worsens the ASQ-SE by 1.3 points). About half of this relationship was mediated by MSE. Postpartum anxiety had an independent adverse effect on SED. PPD and postpartum anxiety have a negative impact on infants' SED. MSE as a mediator may be a potential target for preventive interventions to alleviate the negative effects of maternal psychopathology on infants' SED. The trajectories of postpartum depression (PPD) from 1 month to 6 months were negatively related toinfants' socioemotional development (SED) at age 12 months, underlining the importance of repeated assessment of PPD. Maternal self-efficacy (MSE) mediated the association between PPD and SED, implying MSE could be a potential target for preventive interventions. An additional independent negative effect of postpartum anxiety was identified, implying the assessment of postpartum anxiety also has a surplus value to identify mothers at risk.

Maternal Attachment Networks and Mother-Infant Bonding Disturbances among Mothers with Postpartum Major Depression.

The literature suggests that maternal insecure attachment is a risk factor for postpartum depression which, in turn, affects motherinfant bonding. However, recent research in attachment suggests that the investigation of attachment networks provides further insight in the understanding of psychological outcomes. This study aims to test a model according to which mothers' attachment towards each of their parents contributes to explain attachment towards their romantic partners, which itself is associated with maternal postpartum depression and, in turn, with motherinfant bonding. The Attachment Multiple Model Interview, the Edinburgh Postnatal Depression Scale, and the Postpartum Bonding Questionnaire were administered to 90 mothers of infants under 6 months of age (32 with postpartum major depression). Results showed that attachment towards the partner (1) is best explained by attachment to the father and (2) mediates the link between attachment to the father and depression severity. Also, depression severity mediates the link between attachment to the partner and motherinfant bonding. These results highlight the role of attachment models towards the romantic partner and the father in the perinatal period and the relevance of attachment-focused therapeutic programs in treating postpartum maternal depression.

Maternal Postpartum Depression Screening and Referral in a Latinx Immigrant Population: A Quality Improvement Study.

Postpartum depression (PPD) is the most underdiagnosed obstetric complication in the United States. Left undiagnosed and untreated, PPD can have lasting effects on the infant and the mother. A quality improvement project was conducted to improve rates of screening and referrals with postpartum Latinx immigrant mothers. Community health workers were designated to assist with PPD screening and referral for behavioral health services, at a pediatric patient-centered medical home, using a referral process algorithm (Byatt, N., Biebel, K. & Straus, J. Postpartum Depression Screening Algorithm for Pediatric Providers During Well-Child Visits, MCPAP for Moms: Promoting maternal mental health during and after pregnancy, N/A (2014)). Using chi analysis of pre and post implementation findings, results demonstrated a 21% increase in screening of eligible postpartum mothers. Referrals for behavioral health services also increased from 9 to 22% of patients that screened positive. Community Health Workers were an asset in increasing screening and referral practices for PPD in a Latinx immigrant population. Further research efforts will assist to remove further barriers to PPD screening and treatment.

Effects of kangaroo mother care on maternal and paternal health: systematic review and meta-analysis.

To investigate the effect of kangaroo mother care for low-birth-weight and preterm infants on parents' mental and physical health. The Cochrane Central Register of Controlled Trials, Cochrane Register of Studies Online, PubMed®, Web of Science, Scopus and EMBASE® databases were searched on 16January 2023 for randomized and quasi-randomized trials on kangaroo mother care. Records identified were screened independently by two reviewers. Pooled relative risks (RRs) are reported for categorical variables, and standardized mean differences (SMDs) or mean differences are reported for continuous variables. Evidence quality was assessed using the GRADE approach. The search identified 30 studies involving 7719 preterm or low-birth-weight infants. There was high-certainty evidence that kangaroo mother care substantially reduced the risk of moderate-to-severe postpartum maternal depressive symptoms compared with no kangaroo mother care (RR: 0.76; 95% confidence interval, CI: 0.59 to 0.96). In addition, there was low-certainty evidence that kangaroo mother care reduced scores for maternal stress (SMD: -0.82; 95% CI: -1.32 to -0.32) and anxiety (SMD: -0.62; 95% CI: -1.01 to -0.23) and increased mother-infant attachment and bonding scores (SMD: 1.19; 95% CI: 0.27 to 2.10). Limited evidence indicated father-infant interactions may be improved, though no marked effect on paternal depression or stress was observed. No trial reported parental physical health outcomes. Kangaroo mother care for preterm and low-birth-weight infants was associated with less postpartum maternal depression, stress and anxiety and better mother-infant attachment and bonding. More research is required to evaluate effects on paternal health.

Risk of Postpartum Hemorrhage is Associated With Ethnicity: A Cohort Study of 981,801 Births in England

(BJOG. 2022;129:1269–1277) Postpartum hemorrhage (PPH) is associated with increased risk of maternal morbidity, mortality, and postpartum depression. In the United States, United Kingdom, and beyond, maternal outcomes vary by ethnicity. In the United Kingdom, Black parturients have a higher risk of intensive care unit admission. This study aimed to investigate the association between the risk of PPH and ethnicity, and how socioeconomic background interacts with this association.

Gut Microbiota: a Perspective for Postpartum Depression

Maternal postpartum depression, one of the most prevalent and incapacitating side effects of motherhood, is frequently underdiagnosed and undertreated. However, treatment results are still far from ideal. It has recently come to light that dietary changes are linked to changes in gut flora, which raises health risks and makes people more susceptible to a number of diseases. The gut microbiota plays a significant regulating role in the progression of psychiatric illnesses such postpartum depression. Probiotics and prebiotics have recently acquired popularity in studies on mental health and disease. In this review, the authors explore the connection between postpartum depression and gut microbiota, risk factors and how probiotic bacteria work to lessen symptoms, as well as the possibility of using probiotic bacteria as a useful postpartum depression therapy component.

Maternal childhood trauma and postpartum well-being in a Turkish sample: The path from attachment to alexithymia

Childhood traumas predispose adult individuals to develop insecure attachment styles in close relationships and alexithymia features causing limitations in emotional capacity. For new mothers, postpartum is a period in itself that may increase mood problems such as depression and anxiety and mothers may question their efficacy in their maternal role. Thus, the purpose of the current research was to examine the relationship between maternal childhood trauma, mood problems, and self-efficacy via serial mediation of insecure attachment styles and alexithymia. A sample of postpartum Turkish mothers with healthy singleton infants (N = 63, Mage = 29.19) participated in the research. Mothers filled out the Childhood Trauma Questionnaire-Short Form, the Perceived Maternal Parenting Self-Efficacy Tool, CES-Depression Scale, the State-Trait Anxiety Inventory, the Experiences in Close Relationships Inventory-II, and the Toronto Alexithymia Scale during a home visit when the infants were one month old. In statistical analyses, the PROCESS macro for serial multiple mediation was applied. The results indicated that the relationship between maternal childhood trauma and postpartum depression and anxiety was serially mediated by anxious attachment and, in turn, alexithymia. On the other hand, the serial mediator roles of insecure attachment styles and alexithymia on the relationship between maternal childhood trauma and postpartum self-efficacy were not significant; rather, the direct effect of maternal childhood trauma on postpartum self-efficacy was significant. Findings suggest anxious, rather than avoidant, attachment, and alexithymia as intervention targets to buffer the effects of maternal childhood trauma on postpartum mood problems and self-efficacy, which may consequently prevent the intergenerational transmission of risk.

Postpartum Depression; A Survey of Mothers Attending Paediatric Outpatient Department in A Tertiary Care Centre

Postpartum maternal depression (PPD) prevalence is around 15-20% in low- and middle-income group countries, and it harms the mother and child unit The aim of the study was to find the prevalence of Postpartum maternal depression in mothers attending Paediatric Out Patient Department OPD and to find if there is any correlation with Socio-Economic-Status SES, maternal health condition, pregnancy or obstetric complication, gender of the child, etc. with postpartum depression. A total of 200 mothers attending the pediatric OPD of a tertiary care hospital in a sub-urban area of South India were enrolled. They were interviewed with a semi-structured questionnaire. Details regarding demographic details, education level, employment, marital status, type of family, availability of help to look after the child and to do household chores, substance use in the family members, mental and physical abuse experienced by the mother, if any. Details of psychiatric illness in the family or history of previous postpartum depression were also collected. Screening for postpartum depression was done using Edinburgh postnatal depression scale. The prevalence of PPD was 9%, and interference with child rearing and perception of difficulty in daily activities were significantly associated with PPD. PPD is an underdiagnosed condition. Mothers can be easily screened for pediatric OPD, and treatment can be offered, leading to healthy mothers and children.

Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge.

To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants. We studied 562 self-identified mothers of 641 infants born <30 weeks who were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study (NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy. Standardized medical record reviews ascertained prenatal substance use, maternal and neonatal medical complications. The Edinburgh Postnatal Depression Scale and Brief Symptom Inventory were administered at nursery discharge to screen for PPD and SPD symptoms, respectively. Unadjusted analyses indicated mothers with positive screens for depression (n = 76, 13.5%) or severe distress (n = 102, 18.1%) had more prevalent prepregnancy/prenatal depression/anxiety, and their infants were born at younger gestational ages, with more prevalent bronchopulmonary dysplasia, and discharge after 40 weeks postmenstrual age. In multivariable analyses, prior depression or anxiety was associated with positive screens for PPD (risk ratio [RR]: 1.6, 95% confidence interval [CI]: 1.1-2.2) and severe distress (RR: 1.6, 95% CI: 1.1-2.2). Mothers of male infants had more prevalent depression risk (RR: 1.7, 95% CI: 1.1-2.4), and prenatal marijuana use was associated with severe distress risk (RR: 1.9, 95% CI: 1.1-2.9). Socioenvironmental and obstetric adversities were not significant after accounting for prior depression/anxiety, marijuana use, and infant medical complications. Among mothers of very preterm newborns, these multicenter findings extend others' previous work by identifying additional indicators of risk for PPD and SPD associated with a history of depression, anxiety, prenatal marijuana use, and severe neonatal illness. Findings could inform designs for continuous screening and targeted interventions for PPD and distress risk indicators from the preconception period onward. · Preconceptional and prenatal screening for postpartum depression and severe distress may inform care.. · Prior depression, anxiety, and neonatal complications predicted severe distress and depression symptoms at NICU discharge.. · Readily identifiable risk factors warrant continuous NICU screening and targeted interventions to improve outcomes..

Maternal childhood trauma, postpartum mood problems, and self-efficacy in a Turkish sample: The path from attachment styles to alexithymia

Childhood traumas predispose adult individuals to develop insecure attachment styles in close relationships and alexithymia features causing limitations in an emotional capacity. For new mothers, postpartum is a period in itself that may increase mood problems such as depression and anxiety and mothers may question their efficacy in their maternal role. Thus, the purpose of the current research was to examine the relationship between maternal childhood trauma, mood problems, and self-efficacy via serial mediation of insecure attachment styles and alexithymia. A sample of postpartum Turkish mothers with healthy singleton infants (N = 63, Xage = 29.19) participated in the research. Mothers filled out the Childhood Trauma Questionnaire-Short Form, the Perceived Maternal Parenting Self-Efficacy Tool, CES-Depression Scale, the State-Trait Anxiety Inventory, the Experiences in Close Relationships Inventory-II, and the Toronto Alexithymia Scale during a home visit when the infants were one month old. In statistical analyses, the PROCESS macro for serial multiple mediation was applied. The results indicated that the relationship between maternal childhood trauma and postpartum depression and anxiety was serially mediated by anxious attachment and, in turn, alexithymia. On the other hand, the serial mediator roles of insecure attachment styles and alexithymia on the relationship between maternal childhood trauma and postpartum self-efficacy were not significant; rather, the direct effect of maternal childhood trauma on postpartum self-efficacy was significant. Findings suggest anxious, rather than avoidant, attachment and alexithymia as intervention targets to buffer the effects of maternal childhood trauma on postpartum mood problems and self-efficacy, which may consequently prevent the intergenerational transmission of risk.

Social and Behavioral Problems in School-Aged Children After Maternal Postpartum Depression: A Secondary Analysis of Future of Families and Child Wellbeing Study.

To examine the relation between perinatal depression at child age 1 year and behavioral issues and altered social functioning at school age. The Future of Families (formerly Fragile Families) and Child Wellbeing Study longitudinal cohort age 9 nationally representative urban sample was used to examine associations between maternal depression at child age 1 and child behavior and social functioning at age 9 (n = 2,305 children and their mothers). Measures included the Composite International Diagnostics Interview (depression), Child Behavior Checklist total score (child behavior problems) and social function subscale. Clinical significance of child behavior problems and social function problems were determined by normed T-scores. Analyses included chi square, t-tests, and linear regression using SAS 9.4 Survey procedures. Higher household income was associated with lower behavior problem scores (F = 8.76, p < 0.0001, R2 = 0.07. School-aged children whose mothers had major depression at child age 1 (10.8%) were more than twice as likely to have clinically significant behavior problems (OR 2.46, p < 0.0001) than children whose mothers did not have depression (4.1%). Further, children with depressed mothers were more than twice as likely to have clinically significant social function problems than children whose mothers were not depressed (OR = 2.09, p < 0.0001). Children whose mothers were depressed at child age 1 have higher risk of having behavior problems and poor social functioning at age 9. Early and repeated maternal depression screening is needed to treat the disease sooner and attempt to avoid these outcomes.