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Depression Before and During Pregnancy Linked With Poor Mother-Baby Interaction

Depression during pregnancy and healthy pregnancy but a lifetime history of major depressive disorder are associated with decreased quality of interaction between the mother and the baby, according to a study published online in BJPsych Open.

“Our findings suggest that perinatal mental health professionals should offer support not only to women with depression during pregnancy, but also to pregnant women with a history of depression, as they may also be at risk of interaction difficulties,” said study lead author Rebecca Bind, PhD, a research associate at King’s College London in the United Kingdom. “Future research should try to understand why a history of depression, despite a healthy perinatal period, may impact the developing relationship.”

The study included 131 pregnant women, of whom 51 were healthy, 52 had major depressive disorder (MDD) in pregnancy, and 28 with a history of MDD but not during pregnancy.

Mother-infant pairs in both MDD groups showed reduced quality of interaction compared with the non-MDD group at 8 weeks and 12 months after birth, according to the study. At 8 weeks, 62% of those in the pregnancy MDD group and 56% of those in the history-only MDD group had Crittenden Child-Adult Relationship Experimental-Index scores in the lowest relationship quality category, suggesting the need for therapeutic interventions, compared with 37% in the non-MDD group. At 12 months, 48% of mother-baby pairs in the pregnancy MDD group, 32% of those in the history-only MDD group, and 14% of those in the non-MDD group scored in the lowest relationship category.

Youth With Social Anxiety, Exposure to Maternal MDD Have Higher Depression Risk

The gains between 8 weeks and 12 months in each category, researchers said, suggest that mothers and babies become more attuned to each other over time. Regardless, practical interventions to support the developing relationships are necessary early on, they advised.

“We recommend that healthcare professionals provide pregnant women at risk of interaction difficulties with examples of positive caregiving behaviors, and with ways to engage their babies and understand their needs, all of which could be incorporated into parenting and birth classes and health visits,” said senior author Carmine Pariante, MD, PhD, biological psychiatric professor, King’s College London, and a consultant perinatal psychiatrist at the South London and Maudsley NHS Foundation Trust.

“We also suggest that interventions that can help the mother-infant interaction should be made more widely available, such as video feedback, where a clinician and mother discuss what behaviors work best to engage and comfort the baby, and structured mother-baby activities, such as art and singing groups. This is especially important because we know that the early years are vital for future mental health and wellbeing.”

—Jolynn Tumolo

References

Bind RH, Biaggi A, Bairead A, et al. Mother-infant interaction in women with depression in pregnancy and in women with a history of depression: the Psychiatry Research and Motherhood - Depression (PRAM-D) study. BJPsych Open. 2021;7(3):e100.

Mothers’ depression impacts mother-infant relationships [press release]. London, United Kingdom; King's College London; May 25, 2021.

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