In a research study supported by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC), scientists investigated the potential impact of depression on the mother-infant relationship during pregnancy and postpartum. The researchers examined the quality of interactions between mothers and infants at eight weeks and 12 months after birth, focusing on three groups of women: those without depression, those with clinically significant depression during pregnancy, and those with a history of depression but healthy pregnancies.
Study Findings
The study involved 131 women: 51 were healthy mothers with no history of current or past depression, 52 were mothers with depression who were referred to the South London and Maudsley NHS Foundation Trust Perinatal Psychiatry Services, and 28 were “history-only” mothers with a history of depression but without a current diagnosis.
The findings revealed that both the depression and history-only groups exhibited reduced quality of interactions at both eight weeks and 12 months. Specifically, 62% of mothers with depression during pregnancy and 56% of mothers with a history of depression scored in the lowest category of relationship quality at eight weeks, where therapeutic interventions are recommended, compared to 37% in the healthy group. However, all groups showed improvement in their interaction quality between eight weeks and 12 months, indicating that with time, all mothers and babies can become more attuned to each other.
Furthermore, newborn babies of mothers in the depression and history-only groups displayed decreased social-interactive behavior at six days, which, along with maternal socio-economic difficulties, was predictive of reduced interaction quality. Notably, postnatal depression did not have a significant impact on the mother-infant relationship.
Support
Dr. Rebecca Bind, the lead author and Research Associate at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, suggested that perinatal mental health professionals should offer support not only to women with depression during pregnancy but also to pregnant women with a history of depression, as they may also be at risk of interaction difficulties. Further research is required to understand why a history of depression, even in the absence of current depression, can affect the developing relationship.
Senior author Carmine Pariante, Professor of Biological Psychiatry at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, and Consultant Perinatal Psychiatrist at the South London and Maudsley NHS Foundation Trust, recommended that healthcare professionals provide pregnant women at risk of interaction difficulties with positive caregiving examples and techniques to engage and understand their babies’ needs. Interventions that can improve mother-infant interaction, such as video feedback and structured mother-baby activities like art and singing groups, should be made more widely available, as early years are critical for future mental health and well-being.
The assessment of the mother-infant relationship was conducted using the Crittenden Child-Adult Relationship Experimental Index, which evaluates ‘dyadic synchrony,’ a term describing the overall relationship quality. Researchers analyzed filmed three-minute interactions at eight weeks and 12 months postnatal, scoring the relationship based on seven behavior aspects: facial expression, vocal expression, position and body contact, affection and arousal, turn-taking contingencies, control, and choice of activity. The research team expressed gratitude to the women and infants who participated in the PRAM-D study and to all team members involved in recruiting, collecting, and analyzing the data.
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