Pandemic Impacts Postpartum Mother-Infant Bonding in Multiple Ways

By Marilynn Larkin

October 20, 2021

NEW YORK (Reuters Health) - Pandemic-related grief, particularly depression, increased risks to maternal-infant bonding among postpartum women, whereas anxiety and health worries did not, an online survey shows.

"Screening for postpartum mental health has always been key and it is all the more important now during a pandemic that has profoundly affected the broader population," Dr. Cindy Liu of Brigham and Women's Hospital in Boston. "While more work needs to be done to verify any intervention targets, our results suggests that if we want to promote bonding, it may be wise to channel our energies to addressing maternal depression."

"The extent to which the findings generalize to countries outside of the U.S. likely depends on a number of factors, including the nature of the COVID-19 restrictions in those countries," she said. "Those who had less restrictions may have experienced less grief related to the loss of routines and/or individuals may have felt less stunned or dazed."

"On the other hand, we also know that postpartum depression and anxiety are prevalent across countries, with strong evidence that maternal depression is linked to outcomes that affect the rest of the family," she noted. "While I can only speculate, I do think that our findings could hold true in other countries."

As reported in Pediatric Research, the survey included 429 postpartum women who gave birth in the previous six months and responded to questions about COVID-19-related experiences, pregnancy, stress, and well-being. Participants' mean age was 33.7; 91% were white; 93% were college-educated or higher; and 89% had a household income of $75,000 or more.

The team found that postpartum women's depressive symptoms were related to lower quality maternal-infant bonding, but the anxiety symptoms were not associated with bonding. Maternal self-efficacy, but not social support, was associated with higher levels of maternal-infant bonding.

COVID-19-related health worries also were associated with higher quality of maternal-infant bonding, whereas COVID-19-related grief was significantly associated with lower quality bonding.

The authors note that their study is survey-based, may be subject to participants' recall bias and cannot prove causation. Further, Dr. Liu said, "we have learned that this approach limits us from reaching a more representative sample (and) we are seeking ways to capture the voices of a more diverse mothers who have given birth during this time."

Dr. Polina Umylny, Assistant Director of Pediatric Behavioral Health Integration Program at the Children's Hospital at Montefiore in New York City, commented on the study in an email to Reuters Health. "Regular screening for maternal depression is even more important in the COVID environment. Pediatric primary care offers a critical opportunity for such screenings, as women may be prioritizing their children's medical appointments over their own."

"It is important to use caution when interpreting the finding that maternal COVID-19-related health worries were associated with higher quality maternal-infant bonding in this sample," she noted. "We cannot make the leap that heightened anxiety over COVID-19-related health is protective for the mother-child relationship."

"Parental anxiety...has been shown to play a role in decreased maternal sensitivity, punitive reactions in mothers of older children, and has been shown to 'spill over' into other aspects of the family dynamic, including children's well-being," she said.

"Anxiety over COVID-19-related health concerns as well as COVID-19-related grief will likely look different for women who needed to return to work, in person, shortly after delivery," she noted. "Similarly, women who had a partner or other household member who...needed to continue working outside the home in the first few months of an infant's life, may have had a radically different transition to parenthood than a woman who was able to remain at home, along with her partner, during the height of the pandemic."

"Women who became mothers over the past two years had a uniquely different experience than women who cared for their newborns prior to the start of the pandemic," she said. "The smaller and more isolated social world of the past two years, with fewer resources for the most vulnerable families, has clearly taken a toll on mental health and well-being across the lifespan."

SOURCE: https://go.nature.com/3AWNvus Pediatric Research, online October 14, 2021.

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