Postpartum bonding at the beginning of the second year of child’s life: the role of postpartum depression and early bonding impairment
Abstract
Background: We evaluated the association between mother–child bonding and maternal depression at 6–8 months after birth with bonding impairment at 12–15 months in a sample of mothers at high risk of postnatal depression.Methods: A prospective cohort study with 346 low-income postpartum women with antenatal depression. The Postpartum Bonding Questionnaire (PBQ) and the Patient Health Questionnaire-9 (PHQ-9) were used, at 6–8 and 12–15 months after delivery, to assess the mother–infant bonding and postnatal depression (PPD), respectively.Results: The percentage of the main outcome, bonding impairment (BI) at 12–15 months, was 9.9% (95% CI 6.6–13.7). Using logistic regression models, BI was associated with: having an occupation (OR = 2.82; 95% CI 1.00–7.94, p = .049), unplanned pregnancy (OR = 3.46; 95% CI 1.01–11.8, p = .047), and presence of BI at 6–8 months (OR= 13.0; 95% CI 3.76–45.4, p ≤ .001). Maternal depression was marginally associated with BI at 12–15 months.Conclusions: BI affects 1 in 10 mothers, and although BI and PPD are strongly associated at 6–8 and 12–15 months after delivery, BI at 6–8 months is the main predictor of later BI. Based on the study findings, PPD screening in combination with BI assessment is highly recommended during the first year of child’s life.
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Numerous studies emphasize the importance of early diagnosis and treatment of PPD.
“This notion is supported by numerous studies emphasizing the importance of early diagnosis and treatment of PPD [30, 31].”
From Challenges in diagnosing and treating postpartum depression in the primary care Setting- a qualitative study (2025) · cites this paper as [31]
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
A Screening Questionnaire for mother-infant bonding disorders
Brockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M., Loh, C., & Murdoch, C. (2001) · Archives of Women's Mental Health · doi:10.1007/s007370170010 · Cited by 600 · see citing works
The Postpartum Bonding Questionnaire: a validation
Brockington, I. F., Fraser, C., & Wilson, D. (2006) · Archives of Women's Mental Health · doi:10.1007/s00737-006-0132-1 · Cited by 568 · see citing works
van Bussel, J. C. H., Spitz, B., & Demyttenaere, K. (2010) · Archives of Women's Mental Health · doi:10.1007/s00737-009-0140-z · Cited by 199 · see citing works
Yoshida, K., Yamashita, H., Conroy, S., Marks, M., & Kumar, C. (2012) · Archives of Women's Mental Health · doi:10.1007/s00737-012-0291-1 · Cited by 191 · see citing works
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de Waal, N., Lodder, P., Nyklíček, I., Hulsbosch, L. P., van den Heuvel, M. I., van der Gucht, K., de Caluwé, E., Pop, V. J. M., & Boekhorst, M. G. B. M. (2024) · Early Human Development · doi:10.1016/j.earlhumdev.2024.106082 · Cited by 10 · see citing works
Krepak, D. K., Kopit, A. B., Biderman, A., Yehoshua, I., & Adler, L. (2025) · BMC Primary Care · doi:10.1186/s12875-025-03004-8 · Cited by 1 · see citing works
- Authors
- Faisal-Cury, A., Bertazzi Levy, R., Kontos, A., Tabb, K., & Matijasevich, A.
- Affiliations
- Department of Preventive Medicine, University of São Paulo, São Paulo, Brazil;
- University of Illinois Urbana-Champaign (US)
- Venue
- Journal of Psychosomatic Obstetrics & Gynecology
- Publisher
- Informa UK Limited
- Published
- 2019-08-22
- Volume
- 41
- Issue
- 3
- Pages
- 224-230
- ISSN
- 0167-482X (ISSN-L)
- 1743-8942
- OpenAlex
- W2969559746
- Cited by
- 28
- References
- 5
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 1
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Obstetrics & Gynecology (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- mother-infant bonding, postpartum depression, antenatal depression, low-income mothers, unintended pregnancy, maternal employment, postpartum depression screening, early infancy
- MeSH terms
- Patient Health Questionnaire, Adolescent, Adult, Brazil, Female, Humans, Infant, Mother-Child Relations, Object Attachment, Poverty, Prospective Studies, Cohort Studies, Depression, Postpartum, Young Adult
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