Links among maternal antenatal attachment, postnatal depressive symptoms and infant crying: a prospective cohort study

PurposeThis study investigated whether maternal antenatal attachment (MAA) in the third trimester was associated with self-reported problematic infant crying at eight weeks postnatally and explored links with postnatal depressive symptoms.MethodsA prospective cohort study was conducted with 1287 pregnant participants in Danish general practice. MAA was measured using the Maternal Antenatal Attachment Scale (MAAS) in the third trimester. Both postnatal depressive symptoms and infant crying problems were assessed eight weeks postnatally, using the Edinburgh Postnatal Depression Scale (EPDS) and maternal reports, respectively.ResultsLow MAAS quality scores in the third trimester were initially associated with a 51% increased risk of reporting problematic infant crying at eight weeks, but this effect disappeared after adjusting for physical and mental health variables (e.g., chronic disease, anxiety, and depression symptoms) during pregnancy. No significant effects were found for MAAS intensity or total score. Low MAAS quality and overall MAAS scores were associated with an increased risk of scoring above cutoff on the EPDS. High levels of postnatal depressive symptoms at eight weeks significantly increased the likelihood of reporting problematic infant crying. Low MAAS scores combined with high levels of postnatal depressive symptoms did not increase the risk of problematic infant crying compared to low levels of depressive symptoms with low MAAS scores.ConclusionsOur findings highlight the importance of considering maternal mental health when parents report infant crying problems postnatally. Furthermore, our results demonstrate that poor MAA in pregnancy is not necessarily linked with parental report of problematic infant crying after birth.