Perinatal obsessive–compulsive symptoms and maternal-infant bonding: A longitudinal examination of depression and relationship quality

Perinatal obsessive–compulsive (OC) symptoms are common and distressing, yet their impact on early parenting outcomes such as maternal-infant bonding remains poorly understood. Although prior research links maternal depression and anxiety to bonding difficulties, less is known about how perinatal OC symptoms relate to maternal-infant bonding over time, or the extent to which maternal-partner relationship quality is associated with these outcomes, and whether depressive symptoms explain observed associations. Data were drawn from a longitudinal study of 256 pregnant women recruited from two U.S. sites between 2020 and 2023. Participants completed self-report and clinician-administered assessments at 20 weeks (PGWK20), 34 weeks gestation (PGWK34), and at 6 weeks (PP6WK) and 6 months postpartum (PP6MO). OC symptoms were measured using the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) and the Perinatal Thoughts and Behaviors Checklist (PTBC), depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS), maternal-partner relationship quality with the Dyadic Adjustment Scale (DAS), and maternal-infant bonding with the Postnatal Bonding Questionnaire (PBQ). Prenatal OC symptom severity (PGWK34) and OC symptom severity assessed at PP6WK did not directly predict maternal-infant bonding difficulties at PP6WK or PP6MO. Depressive symptoms at PP6WK significantly mediated the association between prenatal OC symptoms and bonding difficulties at PP6MO. Higher maternal-partner relationship quality during pregnancy (PGWK34) predicted fewer bonding difficulties at PP6MO but was not associated with the strength of associations between OC symptoms and bonding outcomes. Perinatal OC symptoms may indirectly influence maternal-infant bonding through co-occurring depressive symptoms, highlighting the importance of mood-focused assessment and personalized intervention during pregnancy. Maternal-partner relationship quality emerged as a general protective factor associated with fewer bonding difficulties but did not moderate associations between OC symptoms and bonding outcomes. Integrated screening and intervention approaches targeting both mood and OC features may enhance maternal well-being and early relational outcomes.