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Meta-Analysis
. 2023 Aug;26(4):441-452.
doi: 10.1007/s00737-023-01332-1. Epub 2023 Jun 15.

Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis

Gypsy A O'Dea  1 , George J Youssef  2   3 , Lauryn J Hagg  2 , Lauren M Francis  2 , Elizabeth A Spry  2   3   4 , Larissa Rossen  5 , Imogene Smith  2 , Samantha J Teague  2   6 , Kayla Mansour  2 , Anna Booth  7 , Sasha Davies  2   8 , Delyse Hutchinson  2   3   4   9 , Jacqui A Macdonald  2   3   4
Affiliations
Meta-Analysis

Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis

Gypsy A O'Dea et al. Arch Womens Ment Health. 2023 Aug.

Abstract

Purpose: Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed.

Methods: We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress.

Results: We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI - 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = - 0.17 [95% CI - 0.22, - 0.11]).

Conclusion: Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.

Keywords: Maternal-infant bonding; Mental health; Meta-analysis; Perinatal; Systematic review.

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Conflict of interest statement

GO was supported by an Australian Government Research Training Scholarship. ES was supported by an Alfred Deakin Postdoctoral Research Fellowship from Deakin University, Australia. JM and DH received an Australian Research Council Grant (DP160103160) which provided funding to the Australian Temperament Project to collect data on maternal mental health and mother-infant bonding which has been published in one of the included studies in the meta-analysis. Payments were made to JM’s and DH's institution, Deakin University. JM and DH are investigators on the study but did not personally receive funds. DH received an NHMRC Project Grant (APP630517, 2010-14) which provided funding to the Triple B pregnancy cohort study to collect data on maternal mental health and mother-infant bonding which has been published in three of the included studies in the meta-analysis. DH is an investigator on the study but did not personally receive funds. All other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA diagram. Note: *primary reason for exclusion reported if multiple criteria applied to article. Records excluded at full text level, with reason for exclusion, are in supplementary eTable 3. The protocol for this review was registered in 2018 and the review commenced the same year, thus the design followed PRISMA 2009 guidelines that were current at that time
See this image and copyright information in PMC

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