title: Prenatal Predictors of Maternal Attachment and Their Association with Postpartum Depressive Symptoms in Mexican Women at Risk of Depression.
abstract: Objectives Although maternal attachment is an important predictor of infant developmental outcomes, little is known about its pre- and postnatal predictors. The purpose of this secondary data analysis is to assess several risk factors for maternal attachment at 6 months postpartum in a sample of Mexican women at risk of depression. The predictors included were prenatal depressive symptoms, pregnancy intendedness, partner relationship, social support, maternal history of childhood sexual abuse, and postpartum depressive symptoms. Methods A total of 156 pregnant women seeking antenatal care at three health centers were selected because they displayed depressive symptoms (CES-D ≥ 16) or had previously suffered depression. Women were interviewed during pregnancy and at 6 months postpartum. A step-wise multivariate logistic regression was conducted to evaluate the pre- and postpartum risk factors for postpartum depression related to low maternal attachment. Results Pre- and postpartum depressive symptoms increased the risk of low maternal attachment by factors of 3.00 and 3.97, respectively, compared with women who did not present these symptoms; low level of adjustment with the partner increased the risk by a factor of 3.11, low social support by a factor of 2.90, and CSA by a factor of 2.77. Conclusions for practice Prevention programs during pregnancy to reduce depressive symptoms should strengthen strategies to promote maternal attachment by improving partner relations and increasing social support. However, evidence shows that such programs alone are insufficient, so direct interventions should also be implemented. Women with a history of childhood sexual abuse should be given additional attention during prenatal care.
authors.affiliation: Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, 14370, Tlalpan, D.F., Mexico.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Nieto
authors.affiliation: Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, 14370, Tlalpan, D.F., Mexico. laracan@imp.edu.mx.
authors.forename: Ma Asunción
authors.initials: MA
authors.lastname: Lara
authors.affiliation: Ramón de la Fuente Muñiz National Institute of Psychiatry, Calzada México-Xochimilco 101, San Lorenzo Huipulco, 14370, Tlalpan, D.F., Mexico.
authors.forename: Laura
authors.initials: L
authors.lastname: Navarrete
mesh_terms: D003863:Depression / Q000175:diagnosis* / Q000208:ethnology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008800:Mexico; D009769:Object Attachment; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care / Q000379:methods*; D012747:Sexual Partners; D012944:Social Support; D014505:Urban Population; D055815:Young Adult
keywords: Developing country; Maternal attachment; Postpartum depression; Prenatal risk factors