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Postpartum loneliness predicts future depressive symptoms: a nationwide Japanese longitudinal study

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Abstract  

Purpose

The COVID-19 pandemic has intensified feelings of loneliness, especially among postpartum women. This nationwide Japanese longitudinal study assessed the impact of such feelings on depressive symptoms and mother-to-infant bonding difficulties (MIBD), two pivotal determinants of maternal and infant well-being.

Methods

Starting with a baseline survey conducted between July and August 2021, we tracked 1254 postpartum Japanese women who initially reported minimal depressive symptoms (i.e., Edinburgh Postnatal Depression Scale < 9) and MIBD (i.e., Mother-to-Infant Bonding Scale < 5), over a follow-up period of approximately 6 months. Baseline loneliness was evaluated with the UCLA Loneliness Scale Short-Form (UCLA-LS3-SF3).

Results

Forty-nine percent of the sample reported the presence of baseline feelings of loneliness. After propensity score matching on sociodemographics and various pregnancy, childbirth, and COVID-19–related aspects, baseline loneliness was associated with increased risks of later depressive symptoms but not MIBD. Using restricted cubic spline logistic regression and considering loneliness as a continuous variable, we found a positive increasing quadratic relationship with depressive symptoms. As loneliness increased, so did the risk of later depressive symptoms. However, there was no significant association between loneliness and MIBD. These results were confirmed through a sensitivity analysis using inverse probability weighting to address attrition bias.

Conclusion

Feelings of postpartum loneliness are associated with future risks of depressive symptoms. The data suggests that addressing loneliness in postpartum women early is crucial to safeguarding their well-being and that of their infants.

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Funding

This study was supported by the Japan Society for the Promotion of Science KAKENHI Grants [grant numbers JP 21H04856; 20K10467; 20K19633; 20K13721]; the Japan Science and Technology Agency [grant number JPMJSC21U6; JPMJPF2017]; Intramural fund of the National Institute for Environmental Studies; Innovative Research Program on Suicide Countermeasures [grant number: R3-2–2]; Ready for COVID-19 Relief Fund [grant number: 5th period 2nd term 001]; the Health Labor Sciences Research Grant 21HA2016, the grant for 2021–2022 Strategic Research Promotion (No.SK202116) of Yokohama City University) and the research program on “Using Health Metrics to Monitor and Evaluate the Impact of Health Policies,” conducted at the Tokyo Foundation for Policy Research.

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Authors and Affiliations

  1. Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan

    Chong Chen & Shin Nakagawa

  2. Center for Data Science, Waseda University, Tokyo, Japan

    Yasuhiro Mochizuki

  3. Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan

    Sumiyo Okawa

  4. Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan

    Ryo Okubo

  5. Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan

    Takahiro Tabuchi

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  1. Chong Chen
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  2. Yasuhiro Mochizuki
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  5. Shin Nakagawa
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Correspondence to Chong Chen.

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C.C. is the author of Psychology for Pregnancy: How Your Mental Health During Pregnancy Programs Your Baby’s Developing Brain. The other authors declare no competing interests.

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Chen, C., Mochizuki, Y., Okawa, S. et al. Postpartum loneliness predicts future depressive symptoms: a nationwide Japanese longitudinal study. Arch Womens Ment Health (2024). https://doi.org/10.1007/s00737-024-01424-6

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