When loss speaks louder than depression: previous early pregnancy loss as a stronger predictor of mother–infant dyadic disruption

Postpartum depression (PPD) disrupts early mother–infant synchrony, a key determinant of healthy socio-emotional development. The relational impact of prior early pregnancy loss (EPL) remains largely underexplored. This exploratory cross-sectional study examined the independent and combined effects of PPD severity and prior EPL on mother–infant synchrony. Ninety-six mother–infant dyads, recruited from a population vulnerable to depressive symptoms, were assigned to a control group or to one of three PPD severity groups (mild, moderate, severe). Dyadic synchrony was assessed using the CARE-Index, and EPL history was recorded. Chi-square tests and binary logistic regressions evaluated the effects of PPD severity and EPL on low synchrony. EPL significantly predicted low synchrony (OR = 7.50, 95% CI [1.16–48.36], p = 0.034), independently of PPD severity. Although depressive symptoms showed no overall significant effect (p = 0.123), a severity–response trend emerged: mild (OR = 3.06, p = 0.09), moderate (OR = 3.57, p = 0.06), severe (OR = 7.50, p = 0.01). No interaction between EPL and PPD was found. Prior EPL appears to have lasting effects on mother–infant synchrony, independent of current depressive severity. Larger studies are needed to confirm these findings.产后抑郁（Postpartum Depression, PPD）会破坏早期母婴同步性，而该同步性是个体健康社会情绪发展的关键决定因素。既往早期妊娠丢失（Early Pregnancy Loss, EPL）对母婴关系的影响在很大程度上仍未得到充分探索。本探索性横断面研究旨在探究产后抑郁严重程度与既往早期妊娠丢失对母婴同步性的独立及联合影响。本研究从抑郁症状易感人群中招募了96对母婴对，将其分为对照组与三组产后抑郁严重程度组（轻度、中度、重度）。研究采用CARE指数（CARE-Index）评估母婴同步性，并记录受试者的早期妊娠丢失史。采用卡方检验与二元logistic回归分析，评估产后抑郁严重程度及早期妊娠丢失对低同步性的影响。结果显示，在不受产后抑郁严重程度影响的情况下，既往早期妊娠丢失可显著预测低同步性（优势比OR=7.50，95%置信区间CI[1.16–48.36]，p=0.034）。尽管抑郁症状整体未呈现显著影响（p=0.123），但却呈现出严重程度-响应趋势：轻度组（OR=3.06，p=0.09）、中度组（OR=3.57，p=0.06）、重度组（OR=7.50，p=0.01）。未发现早期妊娠丢失与产后抑郁之间存在交互作用。既往早期妊娠丢失似乎对母婴同步性存在持久影响，且该影响独立于当前的抑郁严重程度。未来需开展更大样本量的研究以验证本研究结论。