Maternal postnatal bonding disorder and emotional/behavioral problems in preschool children: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Background: Although there is evidence that maternal perinatal mental disorders are associated with emotional/ behavioral problems in children, the long-term impacts of postnatal bonding disorder remain unclear. We aimed to examine the associations between maternal postnatal bonding disorder and emotional/behavioral problems in preschool children. Methods: We analyzed data from 7220 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Maternal bonding disorder was defined as Mother-to-Infant Bonding Scale score >= 5 at 1 month after delivery. The Child Behavior Checklist for Ages 1'/-5 was used to assess emotional/behavioral problems, and its subscales were used to assess internalizing and externalizing problems in children at 4 years of age. Multiple logistic regression analyses were conducted to examine the associations of postnatal bonding disorder with emotional/behavioral, internalizing, and externalizing problems after adjustment for age, education, income, parity, prenatal psychological distress, postnatal depressive symptoms, child's sex, preterm birth, and birth defects. Results: The prevalence of postnatal bonding disorder was 14.8 %. Postnatal bonding disorder was associated with an increased risk of emotional/behavioral problems in children: the odds ratio (OR) was 2.06 (95 % con-fidence interval [CI], 1.72-2.46). Postnatal bonding disorder was also associated with increased risks of inter-nalizing problems and externalizing problems in children: the ORs were 1.69 (95 % CI, 1.42-2.02) and 1.90 (95 % CI, 1.59-2.26), respectively. Limitations: Bonding and problems were self-reported. Conclusions: Bonding disorder at 1 month after delivery was associated with an increased risk of emotional/ behavioral problems in children at 4 years of age.