Trauma, Depression, Early Attachment, and Neonatal Health Outcomes among African American Mothers and their Infants

Abstract

Young children whose mothers are depressed are vulnerable to a range of negative developmental outcomes beginning during the prenatal period and persisting throughout childhood. There is a large and growing need for evidence-informed pre-and postnatal services for pregnant women, especially in high-risk populations. More research is needed to inform practices relative to identifying pregnant women at risk for depression, providing treatment of depression and its concomitants during pregnancy and the postpartum period, and promoting positive developmental outcomes in infants who have been exposed to perinatal depression. The goal of this study was to enhance our knowledge of perinatal depression (i.e., depression that occurs during pregnancy or within the first 12 months following delivery) as well as its impact on maternal functioning in low-income, African American women and the health and developmental outcomes of their young infants. Participants were low-income African American women (N = 70), recruited during their third trimester of pregnancy, and their newborns. Data collection took place over two time periods: during the third trimester of pregnancy and at one month postpartum. Prenatal data collected include information on a range of risk and protective factors, including prenatal depression, health behaviors, and maternal-fetal attachment (i.e., mother’s feelings of attachment to her unborn child). Postnatal data collected include information on depression, neonatal outcomes (e.g., birth weight), and maternal feelings of attachment to her infant. Multiple regression, logistic regression, and measured variable path analysis were used to test the relationships between risk factors, maternal functioning, and neonatal outcomes. Although his study relied on a small convenience sample of pregnant women, and is not generalizable to a broader population, there are still several findings of note. Marital status and trauma exposure significantly contributed to prenatal depressive symptoms. Also, maternal-fetal attachment mediated the relationship between prenatal depressive symptoms and health practices, but only for participants who were not married or cohabitating. Finally, maternal-fetal attachment significantly predicted maternal-infant attachment. Implications for policy and practice are presented.