Understanding the link between maternal childhood maltreatment and mother-infant bonding: postpartum depressive symptoms as a mediator

<b>Background:</b> Impairments in mother-infant bonding (MIB) during the postpartum period were shown to adversely affect a child's development. Research suggests that such impairments are associated with mothers' own childhood experiences of maltreatment. Hence, understanding factors that mediate this relationship is essential for developing targeted preventive interventions to support mothers who experienced maltreatment in their own childhood during the perinatal period.<b>Objective:</b> As postpartum depression is associated with maternal experiences of childhood maltreatment and impairments in MIB, we aimed to examine the mediating effect of postpartum depression in the relationship between maternal experiences of childhood maltreatment and impairments in MIB.<b>Methods:</b> Longitudinal data from <i>N</i> = 128 mothers in the control group of an eHealth preventive intervention (<i>I-PREGNO</i>) were analysed. Using a path model, we investigated whether the association between maternal childhood maltreatment (measured by the Childhood Trauma Screener) and MIB (measured by the Postpartum Bonding Questionnaire) was mediated by postpartum depressive symptoms (measured by the Edinburgh Postnatal Depression Scale).<b>Results:</b> Postpartum depressive symptoms fully mediated the relationship between maternal experiences of childhood maltreatment and impairments in MIB (indirect effect [<i>ab</i>]: <i>b</i> = .44, <i>p</i> = .001, 95% <i>CI</i> [.18, .70]; direct effect [<i>c'</i>]: <i>b</i> = .01, <i>p</i> = .953, 95% <i>CI</i> [-.38, .41]; total effect [<i>c</i>]: <i>b</i> = .45, <i>p</i> = .041, 95% <i>CI</i> [.02, .89]).<b>Conclusion:</b> Our results highlight the importance of addressing postpartum depression in mothers with childhood maltreatment experiences to promote MIB and to support a healthy start for the child.<b>Trial registration:</b> German Clinical Trials Register identifier: DRKS00031067.