Predictors of infant foster care in cases of maternal psychiatric disorders.
OBJECTIVE
Our aim was to investigate the factors associated with mother-child separation at discharge, after joint hospitalization in psychiatric mother-baby units (MBUs) in France and Belgium. Because parents with postpartum psychiatric disorders are at risk of disturbed parent-infant interactions, their infants have an increased risk of an unstable early foundation. They may be particularly vulnerable to environmental stress and have a higher risk of developing some psychiatric disorders in adulthood.


METHODS
This prospective longitudinal study of 1,018 women with postpartum psychiatric disorders, jointly admitted with their infant to 16 French and Belgian psychiatric mother-baby units (MBUs), used multifactorial logistic regression models to assess the risk factors for mother-child separation at discharge from MBUs. Those factors include some infant characteristics associated with personal vulnerability, parents' pathology and psychosocial context.


RESULTS
Most children were discharged with their mothers, but 151 (15 %) were separated from their mothers at discharge. Risk factors independently associated with separation were: (1) neonatal or infant medical problems or complications; (2) maternal psychiatric disorder; (3) paternal psychiatric disorder; (4) maternal lack of good relationship with others; (5) mother receipt of disability benefits; (6) low social class.


CONCLUSIONS
This study highlights the existence of factors other than maternal pathology that lead to decisions to separate mother and child for the child's protection in a population of mentally ill mothers jointly hospitalized with the baby in the postpartum period.
INSERM, UMRS 953, Maternité de Port Royal, 53 avenue de l'Observatoire, 75014 Paris, France. nine.glangeaud@inserm.fr
Nine M-C
NM
Glangeaud-Freudenthal
Anne-Laure
AL
Sutter-Dallay
Anne-Claire
AC
Thieulin
Véronique
V
Dagens
Marie-Agathe
MA
Zimmermann
Alain
A
Debourg
Corinne
C
Amzallag
Odile
O
Cazas
Rafaële
R
Cammas
Marie-Emmanuelle
ME
Klopfert
Christine
C
Rainelli
Pascale
P
Tielemans
Claudine
C
Mertens
Michel
M
Maron
Sylvie
S
Nezelof
François
F
Poinso
D000328:Adult; D001530:Belgium; D019052:Depression, Postpartum / Q000453:epidemiology*; D005260:Female; D005581:Foster Home Care; D005602:France; D006801:Humans; D007229:Infant Welfare / Q000523:psychology*; D007231:Infant, Newborn; D007398:Interpersonal Relations; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011181:Postnatal Care; D011569:Psychiatric Status Rating Scales; D012923:Social Class