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. 2019 Mar 21;19(1):94.
doi: 10.1186/s12888-019-2067-x.

Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol

Fanie Collardeau  1 , Bryony Corbyn  2 , John Abramowitz  3 , Patricia A Janssen  4 , Sheila Woody  5 , Nichole Fairbrother  6
Affiliations

Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol

Fanie Collardeau et al. BMC Psychiatry. .

Abstract

Background: Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period.

Methods: Participant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse.

Discussion: There is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.

Keywords: Depression; Epidemiology; Infant harm; Intrusive thoughts; OCD; Perinatal.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for this province-wide study was granted by the University of British Columbia Behavioural Research Ethics Board (#H11–03266), the Vancouver Island Health Authority (#H2012–54), Vancouver Coastal Health Authority (#V11–03266) and the Fraser Health Authority (#2013–055). Once they expressed interest in the study, participants were contacted by email by a research team member and sent the first questionnaire. Initial written informed consent for the prenatal assessment (questionnaire and interview at 33 weeks) was obtained from participants via online and/or mailed forms at 33 weeks in pregnancy. Oral consent was again given by participants at the time of the first interview (33-weeks in pregnancy). Written informed consent for the post-partum assessments (both questionnaires and interviews at 7 weeks and 4 months) was obtained using a second consent form at 7 weeks postpartum. Oral consent was again given by participants at the 7-weeks and 4-months interviews. The consent forms conveyed all the necessary information (e.g. project description, purpose, risk and benefits, confidentiality and anonymity, ways to secure the participants’ data) so that the participants were able to make an informed decision about their participation in the study. All participants gave informed consent for the assessment(s) they completed.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participants’ flow through the study
See this image and copyright information in PMC

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