Postpartum Depressive Symptoms and Mother-Infant Bonding: A Mixed-Methods Study Among Postpartum Women in Ghana.

Abstract

Mother-infant bonding difficulties can impair the emotional connection between mother and child and affect child development. We examined the association between postpartum depressive symptoms (PPDS) and mother-infant bonding in the first year postpartum and explored sociocultural factors that may influence bonding. We employed a cross-sectional mixed-methods approach at three health facilities. Surveys included 399 mothers within 12 months postpartum. PPDS were assessed using the Patient Health Questionnaire-9 with a cut-off score > 9, and bonding was measured with the Pre- and Postnatal Bonding Scale. We used a log-normal multivariable regression model to estimate the association between PPDS and mother-infant bonding, adjusting for potential confounders. Qualitative interviews were conducted with 31 mothers (19 with depressive symptoms and 12 without) and were analysed thematically. Overall, 29% of mothers screened positive for depressive symptoms. Screening positive was associated with a small, statistically significant reduction of 3% in bonding (adjusted mean ratio 0.97; 95% confidence interval 0.95-0.99;