Perinatal Depression and Maternal-infant Bonding Disorders in Mothers of Full-term Normal Infants

Abstract

Background: The periods during pregnancy and postnatal are known to be vital for the commencement and progression of mother–infant bonding. A mother suffering from depression in the course of any of these stages may have issues with establishing effective bonding. An evaluation of whether perinatal depression influences postnatal mother-infant bonding has scarcely been researched in Kenya. Methodology: This was a case control study, undertaken in a hospital setup within a period of three months in 2021. Participants were postpartum mothers aged between 18-49 years at 6-12 weeks postpartum attending Mother and child health clinic at Kenyatta National Hospital. Cases were mothers with postpartum bonding disorders per Postpartum Bonding Questionnaire scale while controls were mothers who did not have postpartum bonding disorders. Consecutive type of sampling was employed to recognize participants for the cases. For each case enrolled, there was a simultaneous recruitment and enrollment of two participants as controls. Owing to a comparable larger number of controls, a simple random method was engaged to identify controls from within the same source population as the cases. Two self-report scale tools, Postpartum Bonding Questionnaire scale and Edinburg Postnatal Depression scale were used to obtain data on depression and bonding. A semi-structured questionnaire collected obstetric information, presence of partner support and intimate partner violence. Data analysis was conducted using STATA version 11 and presented in tables and graphs. Statistical significance was set at 5%. Descriptive analysis of key variables was done. Bivariate regression analysis was done between the outcome variable (Mother-Infant Bonding Disorders) and categorical variables. The multivariate analysis that followed allowed for confirmation of whether the borderline or subtle associations were truly significant. Results: A total of 225 mothers (81 primiparous and 144 multiparous) participated in this study. The proportion of women with perinatal depression was 40% in the case group and 9.3% in the control group. The odds of having perinatal depression were 6.48 more in the cases than the controls (OR: 6.48, (95% C.I: 3.16, 13.28) and P-value <0.001).None of the obstetric complications were significantly associated with Mother Infant Bonding Disorders. Assisted delivery was significantly associated with Mother Infant Bonding Disorders (OR: 0.20 95% CI: 0.04, 1.07, P=0.06). The odds of having Mother Infant Bonding Disorders were 79% less likely if the participant had assisted delivery. Conclusion: Mother Infant Bonding Disorders and perinatal depression had an association that was statistically significant. This study concluded that none of the obstetric, social or biomedical factors were significantly associated with mother infant bonding disorder except assisted delivery that was noted to be protective.