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Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia

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Abstract

The association between maternal depressive and anxiety symptoms and impaired bonding with infants were widely studied, but not in fathers and none in Malaysia. We investigated the impact of different trajectories of perinatal depressive and anxiety symptoms on parent-infant impaired bonding during 2–3 months postpartum in both mothers and fathers in two areas of Malaysia. This study originated from a psychiatric morbidity cohort study carried out in health clinics in east and west Malaysia. Edinburgh Postnatal Depression Scale and anxiety subscale of Depression, Anxiety, and Stress Scale at late pregnancy and 2–3 months postpartum and Postpartum Bonding Questionnaire were completed by 566 mothers and 457 fathers. About 11.7% mothers and 16.1% fathers reported depressive symptoms during pregnancy, 6.5% mothers and 10.5% fathers during 2–3 months postpartum, and 3–4% mothers and fathers both depressive and anxiety symptoms 2–3 months postpartum. The mean impaired bonding score was highest in mothers and fathers who had both depressive and anxiety symptoms 2–3 months postpartum. Impaired bonding is associated with higher EPDS and DASS (anxiety subscale) scores 2–3 months postpartum in both parents. Physical partner violence and deteriorated marital relationship were associated with increased risk of impaired bonding in mothers. The association between depressive, anxiety, and comorbidity of depressive and anxiety symptoms in both mothers and fathers and parent-infant impaired bonding during 2–3 months postpartum urges for screening and treatment of depressive and anxiety symptoms in both parents during early parenthood.

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Availability of data and material

The dataset generated and analyzed during the current study are not publicly available due to confidentiality issues but are available from the corresponding author on reasonable request.

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References

  • Asikin AMA, Norhani SS, Arzuar NAR, Azam EO (2019) Reliability and validity of the Malay version of Edinburgh Postpartum Depression Scale (EPDS) when administered to postpartum mothers at two points in time. IIUM Med J Malaysia 18(1). https://doi.org/10.31436/imjm.v18il.226

  • Azidah AK, Nordin R, Ismail SB, Yaacob MJ, Mustapha WMRW (2004) Validation of Malay version of Edinburgh Postnatal Depression Scale. Asia Pac J Fam Med 3:9–18

    Google Scholar 

  • Bell SM, Ainsworth MD (1972) Infant crying and maternal responsiveness. Child Dev 43(4):1171–1190

    CAS  PubMed  Google Scholar 

  • Biaggi A, Conroy S, Pawlby S, Pariante CM (2016) Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Dis 191:62–77

    PubMed  Google Scholar 

  • Bowlby J (1997) Attachment and Loss, Volume 1. Pimlico, London (Original work published 1969)

  • Brady M, Stevens E, Coles L, Zadoroznyj M, Martin B (2017) ‘You can spend time … but not necessarily be bonding with them’: Australian fathers’ constructions and enactments of infant bonding. J Soc Policy 46(1):69–90

    Google Scholar 

  • Brandao S, Figueiredo B (2012) Fathers’ emotional involvement with the neonate: impact of the umbilical cord cutting experience. J Adv Nurs 68(12):2730–2739

    PubMed  Google Scholar 

  • Brockington IF, Oates J, George S, Turner D, Vostanis P, Sullivan M, Lou C, Ourdoch C (2001) Screening questionnaire for mother-infant bonding disorders. Arch Womens Ment Health 3:133–140

    Google Scholar 

  • Brockington I (2004) Postpartum psychiatric disorders. Lancet 363:303–310

    PubMed  Google Scholar 

  • Canario C, Figueiredo B (2017) Anxiety and depressive symptoms in women and men from early pregnancy to 30 months postpartum. J Reprod and Infant Psychol 35(5):431–446

    Google Scholar 

  • Carlberg M, Edhborg M, Lindberg L (2018) Paternal perinatal depression assessed by the Edinburgh Postnatal Depression Scale and the Gotland Male Depression Scale: prevalence and possible risk factors. Am J Mens Health 12(4):720–729

    PubMed  PubMed Central  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150(6):782–786

    CAS  PubMed  Google Scholar 

  • Denckla CA, Mancini A, Conedine NS, Milanovic SM, Basu A, Seedat S, Spies G, Henderson DC, Bonanno GA, Koenen KS (2018) Distinguishing postpartum and antepartum depressive trajectories in a large population-based cohort: the impact of exposure to adversity and offspring gender. Psychol Med 48:1139–1147

    CAS  PubMed  Google Scholar 

  • Dennis C-L, Falah-Hassani K, Shiri R (2017) Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry 210:315–323

    PubMed  Google Scholar 

  • Doucet A (2009) Dad and baby in the first year: gendered responsibilities and embodiment. Anns AAPSS 624(1):78–98

    Google Scholar 

  • Edhborg M, Matthiesen A-S, Lundh W, Widström A-M (2005) Some early indicators for depressive symptoms and bonding 2 months postpartum—a study of new mothers and fathers. Arch Womens Ment Health 8:221–231

    CAS  PubMed  Google Scholar 

  • Edhborg M, Nasreen HE, Kabir Z (2011) Impact of postpartum depressive and anxiety symptoms on mothers’ emotional tie to their infants 2–3 months postpartum: a population-based study from rural Bangladesh. Arch Womens Ment Health 14:307–316

    PubMed  Google Scholar 

  • Edmondson OJH, Psychogiou L, Vlachos H et al (2010) Depression in fathers in the postnatal period: assessment of the Edinburgh Postnatal Depression Scale as a screening measure. J Affect Disord 125:365–368

    PubMed  PubMed Central  Google Scholar 

  • Falah-Hassani K, Shiri R, Dennis C-L (2016) Prevalence and risk factors for comorbid postpartum depressive symptomatology and anxiety. J Affect Disord 198:142–147

    PubMed  Google Scholar 

  • Falah-Hassani K, Shiri R, Dennis C-L (2017) The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis. Psychol Med 47:2041–2053

    CAS  PubMed  Google Scholar 

  • Figueiredo B, Costa R (2009) Mother’s stress, mood and emotional involvement with the infant: 3 months before and 3 months after birth. Arch Womens Ment Health 12:143–153

    PubMed  Google Scholar 

  • Figueiredo B, Conde A (2011) Anxiety and depression in women and men from early pregnancy to 3-months postpartum: parity differences and effects. J Affect Dis 132:146–157

    PubMed  Google Scholar 

  • Figueiredo B, Pacheco A, Costa R (2007) Depression during pregnancy and postpartum period in adolescent and adult Portuguese mothers. Arch Womens Ment Health 10:103–109

    CAS  PubMed  Google Scholar 

  • Figueiredo B, Costa R, Pacheco A, Pais A (2009) Mother-to-infant emotional involvement at birth. Matern Child Health J 13:539–549

    PubMed  Google Scholar 

  • Gelaye B, Rondon M, Araya R, Williams MA (2016) Epidemiology of maternal depression, risk factors and child outcomes in low- and middle-income countries. Lancet Psychiatry 3(10):973–982

    PubMed  PubMed Central  Google Scholar 

  • Giardinelli L, Innocenti A, Benni L, Stefanini M, Lino G, Lunardi C, Svelto V, Afshar S, Bovani R, Castellini G, Faravelli C (2012) Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health 15(1):21–30

    CAS  PubMed  Google Scholar 

  • Government of Malaysia (2010) Tenth Malaysia plan 2011–2015. Putrajaya, the economic planning unit, prime minister’s department

  • Habib C (2012) Paternal perinatal depression: an overview and suggestions towards an intervention model. J Fam Stud 18(1):4–16

    Google Scholar 

  • Habib C, Lancaster SJ (2005) The transition to fatherhood: the level of first-time fathers’ involvement and strength of bonding with their infants. J Fam Stud 11(2):249–266

    Google Scholar 

  • Heron J, O’Connor T, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73

    PubMed  Google Scholar 

  • Hill R, Flanagan J (2020) The maternal-infant bond: clarifying the concept. Int J Nurs Knowl 31(1):14–18

    PubMed  Google Scholar 

  • Hornstein CH, Trautmann-Villalba P, Hohm E, Rave E, Wortmann-Fleischer S, Schwarz M (2006) Maternal bond and mother–child interaction in severe postpartum psychiatric disorders: is there a link? Arch Womens Ment Health 9(5):279–284

    PubMed  Google Scholar 

  • Howe CJ, Cole SR, Lau B, Napravnik SR, Eron JJ Jr (2016) Selection bias due to loss to follow up in cohort studies. Epidemiology 27:91–97

    PubMed  PubMed Central  Google Scholar 

  • Infurna MR, Fuchs A, Fischer-Waldschidt G, Reichl C, Holz B, Resch F, Brunner R, Kaess M (2016) Parents’ childhood experience of bonding and parental psychopathology predict borderline personality disorders during adolescence in offspring. Psychiatry Res 246:373–378

    PubMed  Google Scholar 

  • Kerstis B, Aarts C, Tillman C, Persson H, Engström G, Edlund B, Öhrvik J, Sylvén S, Skalkidou A (2016) Association between parental depressive symptoms and impaired bonding with the infant. Arch Womens Ment Health 19:87–94

    PubMed  Google Scholar 

  • Kita S, Haruna M, Matsuzaki M, Kamibeppu K (2016) Associations between intimate partner violence (IPV) during pregnancy, mother-to-infant bonding failure, and postnatal depressive symptoms. Arch Womens Ment Health 19:623–634

    PubMed  Google Scholar 

  • Klaus MH, Kennell JH (1976) Maternal-infant bonding. Saint Louis, CV Mosby

    Google Scholar 

  • LeMasters K, Andrabi N, Zalla L, Hagaman A, Chung EO, Gallis JA, Turner E-L, Bhalotra S, Sikander S, Maselko J (2020) Maternal depression in rural Pakistan: the protective associations with cultural postpartum practices. BMC Public Health 20:68. https://doi.org/10.1186/s12889-020-8176-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Lutkiewicz K, Bieleninik L, Cie´slak M, Bidzan M, (2020) Maternal–infant bonding and its relationships with maternal depressive symptoms, stress and anxiety in the early postpartum period in a Polish sample. Int J Environ Res Public Health 17:5427. https://doi.org/10.3390/ijerph17155427

    Article  PubMed Central  Google Scholar 

  • Matthey S, Barnett B, Ungerer J, Waters B (2000) Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord 60:75–85

    CAS  PubMed  Google Scholar 

  • Matthey S, Barnett B, Kavanagh DJ, Howie P (2001) Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. J Affect Disord 64(2–3):175–184

    CAS  PubMed  Google Scholar 

  • McNamara J, Townsend ML, Herbert JS (2019) A systemic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLoS ONE 14(7):e0220032. https://doi.org/10.1371/journal.pone.0220032E

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Moehler E, Brunner R, Wiebel A, Reck C, Resch F (2006) Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. Arch Womens Ment Health 9:273–278

    CAS  PubMed  Google Scholar 

  • Murray L, Fiori-Cowley A, Hooper R, Cooper P (1996) The impact of postnatal depression and associated adversity on early motherinfant interactions and later infant outcome. Child Dev 67:2512–2526

    CAS  PubMed  Google Scholar 

  • Murray L, Cooper P, Creswell C, Schofield E, Sack C (2007) The effects of maternal social phobia on mother-infant interactions and infant social responsiveness. J Child Psychol Psychiatry 48:45–52

    PubMed  Google Scholar 

  • Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M (2018) Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia. BMC Psychiatry 18:195. https://doi.org/10.1186/s12888-018-1781-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Nath S, Pearson RM, Moran P, Pawlby S, Molyneaux E, Challacombe FL, Louise M, Howard LM (2019) The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality. J Anxiety Disord 68:102148. https://doi.org/10.1016/j.janxdis.2019.102148

    Article  PubMed  Google Scholar 

  • Nishigori H, Obara T, Nishigori T, Metoki H, Mizuno S, Ishikuro M, Sakurai K, Hamada H, Watanabe Z, Hoshiai T, Arima T, Nakai K, Kuriyama S, Yaegashi N, Miyagi Regional Center of Japan Environment & Children’s Study Group (2020) Mother-to-infant bonding failure and intimate partner violence during pregnancy as risk factors for father-to-infant bonding failure at 1 month postpartum: an adjunct study of the Japan Environment and Children’s Study. J Matern Fetal Neonatal Med 33(16):2789–2796

    PubMed  Google Scholar 

  • Nolvi S, Karlssona L, Bridgett DJ, Pajuloa M, Tolvanena M, Karlsson H (2016) Maternal postnatal psychiatric symptoms and infant temperament affect early mother-infant bonding. Infant Behav Dev 43:13–23

    PubMed  Google Scholar 

  • O’Higgins M, Roberts IS, Glover V, Taylor A (2013) Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. Arch Womens Ment Health 16:381–389

    PubMed  Google Scholar 

  • Parfitt Y, Pike A, Ayers S (2013) The impact of parents’ mental health on parent–baby interaction: a prospective study. Infant Behav Dev 36:599–608

    PubMed  Google Scholar 

  • Park S, Greene MC, Melby MK, Fujiwara T, Surkan PJ (2019) Postpartum depressive symptoms as a mediator between intimate partner violence during pregnancy and maternal infant bonding in Japan. J Interpers Violence. https://doi.org/10.1177/0886260519875561

    Article  PubMed  PubMed Central  Google Scholar 

  • Paulson JF, Dauber SE, Leiferman JA (2006) Individual and combined effects of maternal and paternal depression on parenting behavior. Pediatrics 118:659–668

    PubMed  Google Scholar 

  • Paulson JF, Bazemore SD (2010) Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. JAMA 303(19):1961–1969

    CAS  PubMed  Google Scholar 

  • Ramchandani PG, Domoney J, Sethna V, Psychogiou L, Vlachos H, Murray L (2013) Do early father-infant interactions predict externalising behaviour in young children? Findings from a longitudinal study. J Child Psychol Psychiatry 54(1):56–64

    PubMed  Google Scholar 

  • Ramli M, Mohd AF, Zaini Z (2007) Translation, validation and psychometric properties of Bahasa Malaysia version of the depression, anxiety and stress scale (DASS). Asian J Psychiatry 8:82–89

    Google Scholar 

  • Reck C, Klier CM, Pabst K, Stehle E, Steffenelli U, Struben K, Backenstrass M (2006) The German version of the Postpartum Bonding Instrument: psychometric properties and association with postpartum depression. Arch Womens Ment Health 9:264–271

    Google Scholar 

  • Reck C, Struben K, Backenstrass M, Stefenelli U, Reinig K, Fuchs T, Sohn C, Mundt C (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 118:459–468

    CAS  PubMed  Google Scholar 

  • Reck C, Noe D, Gerstenlauer J, Stehle E (2012) Effects of postpartum anxiety disorders. Infant Behav Dev 35:264–272

    PubMed  Google Scholar 

  • Takaharu M, Watanabe Y, Fukui N et al (2020) Depression, anxiety and primiparity are negatively associated with mother-infant bonding in Japanese mothers. Neuropsychiat Dis Treat 16:3117–3122

    Google Scholar 

  • Taylor A, Atkins R, Kumar R, Adams D, Glover V (2005) A new Mother-to-Infant Bonding Scale: links with early maternal mood. Arch Womens Ment Health 8:45–51

    CAS  PubMed  Google Scholar 

  • Tietz A, Zietlow A-L, Reck C (2014) Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour. Arch Womens Ment Health 17:433–442

    CAS  PubMed  Google Scholar 

  • Tsuchida A, Hamazaki K, Matsumura K, Miura K, Kasamatsu H, Inadera H (2019) Changes in the association between postpartum depression and mother-infant bonding by parity: longitudinal results from the Japan Environment and Children’s study. J Psychiatr Res 110:110–116

    PubMed  Google Scholar 

  • Underwood L, Waldie KE, D’Souza S, Peterson E, Morton SMB (2016) A review of longitudinal studies on antenatal and postnatal depression. Arch Womens Ment Health 19:711–720

    PubMed  Google Scholar 

  • Wittkowski A, Wieck A, Mann S (2007) An evaluation of two bonding questionnaires: a comparison of the Mother-to-Infant Bonding Scale with the Postpartum Bonding Questionnaire in a sample of primiparous mothers. Arch Womens Ment Health 10:171–175

    CAS  PubMed  Google Scholar 

  • Wee KY, Skouteris H, Pier C, Richardson B, Milgrom J (2011) Correlates of ante-and postnatal depression in fathers: a systematic review. J Affect Dis 130:358–377

    PubMed  Google Scholar 

  • Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG (2017) A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord 219:358–377

    Google Scholar 

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Acknowledgements

The authors thank all clinic nurses and staff involved in helping the data collection. The authors also express gratitude to the women who participated in the study for generously giving their time and energy and providing personal details to the interviews.

Funding

The study was supported by grants from the Ministry of Higher Education, Malaysia, under the Fundamental Research Grant Scheme (FRGS15-238–0479).

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Authors and Affiliations

  1. Department of Community Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia

    Hashima E. Nasreen, Hafizah Binti Pasi, Jamalludin Ab Rahman & Razman Mohd Rus

  2. Department of Family Medicine, Faculty of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia

    Mohd Aznan Md Aris

  3. Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 141 83 Huddinge, Stockholm, Sweden

    Maigun Edhborg

Authors
  1. Hashima E. Nasreen
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  2. Hafizah Binti Pasi
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  3. Mohd Aznan Md Aris
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  4. Jamalludin Ab Rahman
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  5. Razman Mohd Rus
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Contributions

Hashima E. Nasreen (H. E. N.), Hafizah Binti Pasi (H. B. P.), Mohd Aznan Md Aris (M. A. M. A.), Jamalludin Ab Rahman (J. A. R.), Razman Mohd Rus (R. M. R.), and Maigun Edhborg (M. E.) participated in the planning and conception of the research questions and the study design. H. E. N. was the principal investigator of the study and primarily conceptualized the research. H. B. P., S. M. R., M. A. M. A., and R. M. R. were responsible for retrieving the data, and H. E. N. was responsible for analyzing the data. J. A. R. provided statistical expertise. H. E. N. and M. E. participated in interpreting the data and drafted the article. All authors critically revised the manuscript for important intellectual content. All authors read and approved the manuscript.

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Correspondence to Hashima E. Nasreen.

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Ethical approval

The study was approved by the Malaysia Medical Research and Ethics Committee (NMRR-15–1902-28439) and the Research Ethics Committee of International Islamic University Malaysia (IREC 555).

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Women and men were informed in detail about the study and written informed consent was obtained.

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Not applicable.

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The authors declare no competing interests.

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Nasreen, H.E., Pasi, H.B., Aris, M.A.M. et al. Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia. Arch Womens Ment Health 25, 377–387 (2022). https://doi.org/10.1007/s00737-021-01165-w

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