Associations of Perceived Parenting Practices with Mother–Infant Bonding at 1-Month Postpartum via Adult Attachment, Depression, and Anxiety in Japanese Mothers

Purpose: This study aimed to examine the direct and indirect association between perceived parenting practices to postpartum bonding difficulties, considering the mediating roles of adult attachment, depression, and anxiety. Methods: In this cross-sectional study conducted at 1 month postpartum, 2901 Japanese women were recruited from 34 obstetric institutions in Niigata Prefecture. Participants completed the Parental Bonding Instrument, the Relationship Questionnaire, the Hospital Anxiety and Depression Scale, and the Mother-to-Infant Bonding Scale to examine perceived parenting practice, adult attachment style, anxiety, depression, and bonding, respectively. Structural equation modeling with 2000 bootstrap resamples was used to evaluate both direct and indirect associations between variables. Results: Participants had a mean age of 32.16 years. The path model demonstrated acceptable-to-good fit (comparative fit index = 0.949, Tucker-Lewis Index = 0.908, and root mean square error of approximation = 0.064). Paternal and maternal parenting were significantly correlated with adult attachment style (r = 0.297 and 0.200, respectively), which in turn was significantly associated with depression (r = -0.236) and anxiety (r = - 0.307). Sequentially, depression and anxiety were associated with lack of affection (r = 0.313 and 0.172, respectively) and anger and rejection (r = 0.113 and 0.203, respectively). An indirect association was observed between parenting and bonding via two routes: one sequentially through attachment style and depression and anxiety, and another through depression and anxiety alone. Maternal parenting showed a direct negative association with lack of affection (r = -0.108). All correlations were statistically significant (P < 0.05). Conclusion: Perceived parenting practices were significantly associated with bonding via adult attachment, depression and anxiety. These findings support integrating perinatal screening and interventions into clinical practice. Future longitudinal research is needed to clarify the causal pathways and the role of paternal and maternal intergenerational caregiving in women's mental health, while also testing motivational parenting interventions.