Identifying subtypes based on environmental and neurobiological risk and resilience factors of postpartum maternal mental health

Transition into parenthood introduces profound changes in the birthing parent's brain. Despite the pivotal impact of the perinatal period on caregiving behaviors and offspring development, research on the risk factors influencing maternal mental health remains limited. Given the increased experience-dependent neuroplasticity during this period, we investigated environmental and neurobiological factors related to postpartum mental health. We leveraged two brain metrics (regional gray matter volume, task-based functional connectivity) and extensive environmental survey and interview responses from 87 mothers (M_age = 29.71) as an input to data clustering method, similarity network fusion (SNF). Group differences of in-model variables and out-of model mental health measures between the resultant clusters were compared by statistical testing. SNF identified three clusters that were differentiated based on the behavioral and clinical assessments and multimodal neural features that support functions associated with emotional processing and symptoms of depression and anxiety. Importantly, cluster classifications successfully detected group differences in postpartum mood symptoms that were not included in SNF model. Our findings profiled risk and resilience factors of the perinatal period and highlight the need for preventive therapeutic interventions and social policies to create a more protective early environment for both the parents and their offspring.