P3B303: Infant Emotionality Is Associated with More Severe Symptoms of Depression at 6 Months Postpartum

Background: Postpartum depression (PPD) affects at least 1 in 8 women who experience childbirth and is associated with many complications, ranging from social isolation and difficulty returning to the workforce, to suicide in severe cases. There is evidence of negative impacts of PPD on the mother-infant relationship, including effects on perceived parenting ability and poor infant attachment. However, little attention has been given to the potential impact of infant characteristics on development or severity of PPD. There is preliminary evidence that an infant’s degree of emotional arousal, distress, or irritability may contribute to a woman’s risk for PPD, but little research has been conducted to better understand these relationships. The purpose of this cross-sectional study was to determine if greater infant emotionality is associated with symptoms of maternal depression at 6 months postpartum.

Methods: Secondary data were obtained from a longitudinal study that examined maternal depression during pregnancy and the first year postpartum. Data from 70 women were included in this analysis. Women completed a demographic questionnaire and depression assessment during their 3rd trimester of pregnancy. At 6 months postpartum, they completed an additional measure of depression and an infant temperament questionnaire. Mother and infant also participated in a stressor protocol (the Still Face Paradigm; SFP) at this time. The negative affectivity scale from the temperament measure and standardized ratings of emotional distress in response to the SFP were our measures of infant emotionality. We used linear regression to determine the relationship of infant negative affectivity and emotional distress to mothers’ PPD, controlling for depressive symptoms during pregnancy and prior diagnosis of depression.

Results: On average, women were 36 (± 5.0) years of age, with 85% in a committed relationship. 28% had a prior depression diagnosis. Postpartum depression ranged from asymptomatic to severe, with 10% of women meeting the cutoff for Major Depressive Disorder. Infants had an average gestational age of 38 weeks and 56% were girls. 22% of mothers and infants were African or Asian American and 25% were Hispanic. Infant negative affectivity (β=0.24, p=0.011) and degree of emotional distress in response to the SFP (β =0.24, p=0.010) were significantly associated with mother’s depressive symptoms, while controlling for diagnosis of depression prior to or during pregnancy. Variables in the model accounted for 45% of the variance in PPD (F=13.49, p=0.000). Supplemental longitudinal analyses supported the direction of effects.

Conclusion: Findings indicate the importance of infant emotionality as a potential factor contributing to PPD and the need for early assessment of infant behavior and mother-infant interactions, especially among women with a history of depression. Interventions can then be initiated to assist mothers in caring for infants whose more challenging affective behaviors may contribute to development or worsening of PPD symptoms.