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. 2025 Jun 7;25(1):667.
doi: 10.1186/s12884-025-07762-2.

Postpartum depression and maternal-infant bonding: the mediating role of mentalizing and parenting self-efficacy

Weijing Qi #  1 , Ziqi Wei #  1 , Huicong Lv  1 , Jinping Zhao  1 , Yuanyuan Hu  1 , Yitong Wang  1 , Qing Guo  2 , Jie Hu  3
Affiliations

Postpartum depression and maternal-infant bonding: the mediating role of mentalizing and parenting self-efficacy

Weijing Qi et al. BMC Pregnancy Childbirth. .

Abstract

Background: The accumulated evidence suggested that postpartum depression was mainly associated with maternal-infant bonding. However, this link needed to be further explained by potential mediating factors. This study aimed to investigate the impact of postpartum depression on maternal-infant bonding, examining the mediating roles of mentalizing and parenting self-efficacy.

Methods: A sample of 390 postpartum women was recruited from a maternity hospital around four weeks postpartum. A multiple mediating analysis was conducted to investigate how mentalizing and parenting self-efficacy affected the relationship between postpartum depression and maternal-infant bonding.

Results: The mediation analyses indicated that postpartum depression had a direct negative impact on maternal-infant bonding among postpartum women. It could also exert an indirect effect via three pathways: the independent mediation of parenting self-efficacy, the serial mediation of hypermentalizing and parenting self-efficacy, and the serial mediation of hypomentalizing and parenting self-efficacy.

Limitations: Women were sampled from a single maternity hospital, and self-report measures were utilized. The cross-sectional design also limited conclusions about causation and directionality.

Conclusions: The findings suggest that postpartum depression may negatively affect maternal-infant bonding. Moreover, the significant roles of a mother’s mentalizing and parenting self-efficacy in the relationship between postpartum depression and maternal-infant bonding should not be overlooked. These results could offer insights into supporting women with postpartum depressive symptoms to establish positive mother-infant relationships.

Clinical trial number: No. 20230128.

Keywords: Maternal-infant bonding; Mentalizing; Parenting self-efficacy; Postpartum depression.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval for this study was granted by the Ethics Committee of Shijiazhuang Obstetrics and Gynecology Hospital (No. 20230128). The study was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Multiple mediating paths between postpartum depression and maternal-infant bonding (mediating effects of hypermentalizing and parenting self-efficacy). Standardized coefficients were reported for each path. Note: ***P < 0.001, **P < 0.01, *P < 0.05
Fig. 2
Fig. 2
Multiple mediating paths between postpartum depression and maternal-infant bonding (mediating effects of hypomentalizing and parenting self-efficacy). Standardized coefficients were reported for each path. Note: ***P < 0.001, **P < 0.01, *P < 0.05
See this image and copyright information in PMC

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