The relationship between maternal mental health in the postpartum period and infant’s temperament

Abstract

Abstract Background and purpose: Mild degrees of depression and anxiety symptoms are normal during the postpartum period, which is in fact a natural response for facing the situation, but these symptoms may become more severe and prolonged, and therefore, if this period would not be managed well, at last, it could lead to maternal distress (depression and anxiety). Infant temperament is defined as individual biological differences in reactivity and self-regulation in response to environmental stimuli. The reactivity component includes delay, intensity, and duration of emotional, attentional, and movement responses to stimuli. The self-regulation component includes the way and ability to adjust these reactions, besides. Mother's depression and distress can probably affect the infant's temperament and the infant's low mood can also affect the mother's depression and anxiety. The purpose of this study is to determine the relationship between the mother's mental health during after postpartum period with infant’s temperament. Material and methods: This study is a cross-sectional study conducted on 167 mothers and four-month-old infants who referred to 56 health-treatment centers in Tabriz city in the year 1400-1401. The inclusion criteria for this study included inclination to participate in the study, mother's age over 19 years, having the ability to read and write, living in Tabriz city (to complete the study in Tabriz health centers), giving birth 4 months before, healthy infant without abnormalities, and the exclusion criterion multiple pregnancy. The data was collected using the questionnaires of social-individual characteristics, Edinburgh postpartum depression scale (EPDS), postpartum distress, and revised the Infant Behavior Questionnaire-Revised (IBQ-R). For analyzing the relationship between individual and social characteristics with postpartum depression and distress, first two-variable tests including Independent sample t-test and one-way analysis of variance (ANOVA) were used, then to control confounding variables, those independent variables that their P-value in the two-variable test were less than 0.2, entered the multivariate linear regression model with Backward strategy. Results: The mean (standard deviation) of EPDS was 7.15 (4.79) from a possible score of 0 to 30. The mean (standard deviation) of the postpartum distress score was 5.92 (4.3) from the obtainable score of 0 to 48. In the IBQ-R, the mean (standard deviation) score of the subdomain of “positive affectivity/surgency” was 30.35 (5.53) from a possible score of 6 to 42. The mean (standard deviation) score of the “negative affectivity” subdomain is 16.11 (4.53) from a possible score of 4 to 28, and the mean (standard deviation) of the “orienting/regulatory capacity” subdomain score is 21.95 (3.8) from a possible score of 4. It was until the 28th. According to Spearman's correlation test, among the infant temperament variables, there was only a significant inverse relationship between activity level scale and postpartum depression (r = -0.14 and P = 0.047). Also, there was a significant inverse relationship between infant Orienting/Regulatory Capacity subdomain and postpartum distress (P=0.005 and r=-0.21). The highest degree of inverse correlation between postpartum distress and Soothability (r=-0.36) and the lowest degree of inverse correlation was between postpartum distress and the Falling Reactivity (r=-0.15). According to the linear regression test, insufficient household income was among the risk factors and predictors of the infant's Negative Affectivity subdomain. [p=0.029 B=0.169, CI 95%:0.25 to 1.31]. Also, postpartum depression was among the risk factors and predictors of infant self-regulation subscale and this relationship was inverse [p=0.021 B=-0.179, CI 95%:-0.25 to -0.02]. Conclusion: According to the results of this study, the infant's temperament has relation with depression and postpartum distress of the mother, therefore, identifying women who have risk factors for postpartum depression and distress or have early symptoms including postpartum grief and instructing them in this field can be beneficial in improving the mood and temperament of infants. Also, considering that in prenatal care, more emphasis is placed on the physical care of the mother and usually the psychological care of the mother is neglected, more emphasis should be placed on preparing pregnant mothers to accept the role of motherhood and improvement of the relationship between mother and child.