Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis

O'Dea, Gypsy A., Youssef, George J., Hagg, Lauryn J., Francis, Lauren M., Spry, Elizabeth, Rossen, Larissa, Smith, Imogene, Teague, Samantha J., Mansour, Kayla, Booth, Anna, Davies, Sasha, Hutchinson, Delyse, and Macdonald, Jacqui A. (2023) Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis. Archives of Women's Mental Health, 26. pp. 441-452.

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Purpose: Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed.

Methods: We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress.

Results: We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI − 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = − 0.17 [95% CI − 0.22, − 0.11]).

Conclusion: Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures.

Item ID: 79151
Item Type: Article (Research - C1)
ISSN: 1435-1102
Copyright Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Date Deposited: 29 Jun 2023 22:49
FoR Codes: 52 PSYCHOLOGY > 5203 Clinical and health psychology > 520302 Clinical psychology @ 80%
52 PSYCHOLOGY > 5201 Applied and developmental psychology > 520101 Child and adolescent development @ 20%
SEO Codes: 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health @ 100%
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