Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

Abstract

The parent-infant bond following childbirth is an important facilitator of optimal infant development. So far, research has mainly focused on mother-infant bonding. Data on fathers are still sparse. Parental mental health, such as posttraumatic stress symptoms (PTSD), may influence mother-infant relations and/or interactions. There is evidence that both parents can experience PTSD symptoms following childbirth (PTSD-CB). The aim of this study is to investigate the prospective relationship between parental PTSD-CB symptoms at 1 month postpartum and perceived parent-infant bonding at 3 months postpartum, while adjusting for antenatal confounders. A subsample was used for this study ( n Totalsample 488, n mothers = 356, n fathers = 132) of an ongoing prospective cohort study. Future parents awaiting their third trimester antenatal appointments at a Swiss university hospital were recruited. Self-report questionnaires assessed PTSD-CB symptoms and psychological distress at 1 month postpartum, and parent-infant bonding at 3 months postpartum. Confounders included antenatal PTSD symptoms and social support measured via self-report questionnaires, and gestity and gestational age, extracted from medical records. Using structural equation modeling, the predictive ability of PTSD-CB symptoms at 1 month postpartum on parent-infant bonding at 3 months postpartum was assessed for both parents respectively. Maternal PTSD-CB symptoms at 1 month postpartum were found to be negatively prospectively associated with mother-infant bonding at 3 months postpartum; however, this effect disappeared after adjusting for psychological distress at 1 month postpartum. No such effects were found for fathers. There was no evidence of mediation of the relationship between parental PTSD-CB symptoms at 1 month postpartum and parental-infant bonding at 3 months postpartum via psychological distress at 1 month postpartum. However, such a mediation was found for maternal intrusion and hyperarousal symptom subscales. Results expand the current literature on the impact of PTSD-CB on parent-child relations to also include fathers, and to a community sample. Any adverse effects of mental health symptoms on parent-infant bonding were evidenced by 3 months postpartum only for mothers, not fathers. Our results may inform the development of prevention/intervention strategies.

From Hypnos to Ephialtes: waking up to the consequences of accidental awareness during obstetric general anaesthesia

“…The incidence of PTSD reported in this study is broadly consistent with previous reports in other patient populations [22]. Unlike other patients, however, the effect of PTSD is not just limited to the mother but also extends to her offspring; post-partum PTSD is associated with failed initiation of breastfeeding, a negative impact on the social-emotional development of children at 2 years of age, and arguably, impaired maternal-infant bonding [23][24][25]. Therefore, early recognition of AAGA and subsequent intervention is paramount to minimising the long-term consequences for the mother-infant dyad.…”

Physical and Psychological Childbirth Experiences and Early Infant Temperament

“…These findings could mean that depressed mothers perceive their infant as more difficult ( McGrath et al, 2008 ). Furthermore, they may indicate that the mother’s personal feelings of birth trauma, represented here by negative birth and postnatal emotional states, such as Anxious-Afraid, Neglected and Postnatal Distress, contribute equally to PPD and CB-PTSD, with an adverse impact on mother–infant bonding ( Stuijfzand et al, 2020 ), in turn affecting infant temperament. Alternatively, a challenging birth experience could lead directly to increased unsettled infant behaviour via physiological pathways, as discussed.…”

Psychological risks to mother–infant bonding during the COVID-19 pandemic

“…78 As well, parents of medically fragile infants who were admitted to the NICU may feel emotionally distant from their infants, 79 as a result of their acute grief response to their child's medical diagnosis. 80 Traumatic birth and non-vaginal births have also been associated with challenges in maternal bonding [81][82][83] that may reflect some avoidance of the infant as they may serve as a reminder of the birth trauma. While grief was not directly assessed, previous work on widescale trauma found that mothers exposed to war trauma had lower levels of emotional availability.…”