Understanding the link between maternal childhood maltreatment and mother-infant bonding: postpartum depressive symptoms as a mediator

<b>Background:</b> Impairments in mother-infant bonding (MIB) during the postpartum period were shown to adversely affect a child’s development. Research suggests that such impairments are associated with mothers’ own childhood experiences of maltreatment. Hence, understanding factors that mediate this relationship is essential for developing targeted preventive interventions to support mothers who experienced maltreatment in their own childhood during the perinatal period. <b>Objective:</b> As postpartum depression is associated with maternal experiences of childhood maltreatment and impairments in MIB, we aimed to examine the mediating effect of postpartum depression in the relationship between maternal experiences of childhood maltreatment and impairments in MIB. <b>Methods:</b> Longitudinal data from <i>N</i> = 128 mothers in the control group of an eHealth preventive intervention (<i>I-PREGNO</i>) were analysed. Using a path model, we investigated whether the association between maternal childhood maltreatment (measured by the Childhood Trauma Screener) and MIB (measured by the Postpartum Bonding Questionnaire) was mediated by postpartum depressive symptoms (measured by the Edinburgh Postnatal Depression Scale). <b>Results:</b> Postpartum depressive symptoms fully mediated the relationship between maternal experiences of childhood maltreatment and impairments in MIB (indirect effect [<i>ab</i>]: <i>b</i> = .44, <i>p</i> = .001, 95% <i>CI</i> [.18, .70]; direct effect [<i>c’</i>]: <i>b</i> = .01, <i>p</i> = .953, 95% <i>CI</i> [−.38, .41]; total effect [<i>c</i>]: <i>b</i> = .45, <i>p</i> = .041, 95% <i>CI</i> [.02, .89]). <b>Conclusion:</b> Our results highlight the importance of addressing postpartum depression in mothers with childhood maltreatment experiences to promote MIB and to support a healthy start for the child. <b>Trial registration:</b>German Clinical Trials Register identifier: DRKS00031067. The current article examines the mediating effect of postpartum depression in the relationship between maternal experiences of childhood maltreatment and impairments in MIB during the postpartum period.Postpartum depressive symptoms fully mediated the relationship between childhood maltreatment and impairments in MIB.The results of the current article highlight the importance of addressing postpartum depression in mothers with childhood maltreatment experiences to promote MIB and to support a healthy start for the child. The current article examines the mediating effect of postpartum depression in the relationship between maternal experiences of childhood maltreatment and impairments in MIB during the postpartum period. Postpartum depressive symptoms fully mediated the relationship between childhood maltreatment and impairments in MIB. The results of the current article highlight the importance of addressing postpartum depression in mothers with childhood maltreatment experiences to promote MIB and to support a healthy start for the child.

**背景**：产后母婴依恋（mother-infant bonding, MIB）受损已被证实会对儿童的发育产生不利影响。已有研究表明，这类母婴依恋受损与母亲自身童年期遭受虐待的经历存在关联。因此，明确介导这一关联的影响因素，对于开发针对性预防干预措施、支持围产期曾经历虐待的母亲而言至关重要。**研究目的**：鉴于产后抑郁与母亲童年虐待经历及母婴依恋受损均存在相关性，本研究旨在检验产后抑郁在母亲童年虐待经历与母婴依恋受损之间的关系中所发挥的中介效应。**研究方法**：本研究对某电子健康预防干预项目（I-PREGNO）对照组中N=128名母亲的纵向数据展开分析。通过构建路径模型，本研究探究了母亲童年虐待经历（采用童年创伤筛查量表（Childhood Trauma Screener）评估）与母婴依恋状况（采用产后依恋问卷（Postpartum Bonding Questionnaire）评估）之间的关联，是否可由产后抑郁症状（采用爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）评估）所介导。**研究结果**：产后抑郁症状在母亲童年虐待经历与母婴依恋受损之间发挥了完全中介效应（间接效应[ab]：b=0.44，p=0.001，95%置信区间（CI）[0.18, 0.70]；直接效应[c’]：b=0.01，p=0.953，95%CI[-0.38, 0.41]；总效应[c]：b=0.45，p=0.041，95%CI[0.02, 0.89]）。**研究结论**：本研究结果凸显了对存在童年虐待经历的母亲开展产后抑郁干预的重要性，该干预有助于改善母婴依恋状况，为儿童奠定健康的发展开端。**试验注册**：德国临床试验注册库编号：DRKS00031067。本文旨在检验产后抑郁在母亲童年虐待经历与产后时期母婴依恋受损之间关系中的中介效应。产后抑郁症状在童年虐待经历与母婴依恋受损之间发挥了完全中介效应。本研究结果凸显了对存在童年虐待经历的母亲开展产后抑郁干预的重要性，该干预有助于改善母婴依恋状况，为儿童奠定健康的发展开端。本文旨在检验产后抑郁在母亲童年虐待经历与产后时期母婴依恋受损之间关系中的中介效应。产后抑郁症状在童年虐待经历与母婴依恋受损之间发挥了完全中介效应。本研究结果凸显了对存在童年虐待经历的母亲开展产后抑郁干预的重要性，该干预有助于改善母婴依恋状况，为儿童奠定健康的发展开端。