Maternal lifetime history of depression and depressive symptoms in the prenatal and early postnatal period do not predict infant–mother attachment quality in a large, population-based Dutch cohort study

Abstract

We examined the effects of maternal history of depressive disorder and the effects of depressive symptoms during pregnancy and the early postpartum period on attachment insecurity and disorganization. A total of 627 mother–infant dyads from the Generation R Study participated in a population-based cohort from fetal life onwards. Maternal history of depression was assessed by diagnostic interviews during pregnancy; maternal peri- and postnatal depressive symptoms were assessed with questionnaires in 506 of these women at 20 weeks pregnancy and two months postpartum; and infant–mother attachment security was observed when infants were aged 14 months. A history of maternal depressive disorder, regardless of severity or psychiatric comorbidity, was not associated with an increased risk of infant attachment insecurity or disorganization. Likewise, maternal peri- and postnatal depressive symptoms were not related to attachment insecurity or disorganization at 14 months. These results are important because mothers from otherwise low risk backgrounds often have previously been depressed or are struggling with non-clinical depressive symptoms during pregnancy and after giving birth. Our findings are discussed in terms of protective factors that may limit the potentially negative effects of maternal depressive symptoms on the infant–mother attachment relationship in the general population. The role of selective attrition and lack of information about the mothers' attachment status for the current null-findings are also discussed.

Keywords:

• infant–mother attachment
• disorganized attachment
• maternal depression
• population-based
• cohort

Acknowledgements

The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the Faculty of Social Sciences of the Erasmus University, the Municipal Health Service Rotterdam area, the Rotterdam Homecare Foundation and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR). We gratefully acknowledge the contribution of general practitioners, hospitals, midwives and pharmacies in Rotterdam.