Postnatal Bonding in the First Year After Birth: The Role of Maternal Depression, Resilience, and Anxiety During the COVID-19 Pandemic and War-Related Stress—A Prospective Cohort Study

TL;DR

This study explores how maternal depression and resilience affect the emotional bond between mothers and infants during the first year after birth, especially during the pandemic and war-related stress.

Contribution

The study identifies maternal depressive symptoms and resilience as key factors influencing postnatal bonding during the first year, including pandemic and war-related stress.

Findings

Postnatal bonding difficulties were most common at 4–6 weeks postpartum and decreased over time.

Maternal depressive symptoms showed the strongest and most consistent associations with bonding difficulties.

Higher resilience, especially in family relations and social competence, was linked to better bonding outcomes.

Abstract

Background: Postnatal bonding reflects the early emotional relationship between a mother and her infant and is shaped by psychological and perinatal factors. This study examined associations between postnatal bonding and maternal depressive symptoms, resilience, labor anxiety, and sociodemographic and health-related variables, as well as anxiety related to the COVID-19 pandemic, the war in Ukraine, and global events. Methods: This prospective cohort study included and followed 150 pregnant women in Poland from pregnancy to 12 months postpartum. Assessments were conducted during pregnancy and at 4–6 weeks, 6 months, and 12 months after delivery. Postnatal bonding was assessed using the PBQ, depressive symptoms with the EPDS, labor anxiety with the LAQ, resilience with the KOP-26, and anxiety related to external stressors with study-specific questionnaires. Non-parametric analyses were performed with a significance level of p < 0.05. Results: Postnatal bonding difficulties were most prevalent at 4–6 weeks postpartum (26.1%) and decreased over time. Maternal depressive symptoms showed the strongest and most consistent associations with bonding difficulties, whereas higher resilience, particularly in family relations and social competence, was associated with better bonding outcomes. Labor anxiety was weakly associated with bonding only in the early postpartum period, while no associations were found with sociodemographic characteristics or anxiety related to external societal stressors. Conclusions: Maternal depressive symptoms and resilience emerged as the key factors associated with postnatal bonding quality, highlighting their importance as targets for early identification and intervention.

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