Pre-conception self-harm, maternal mental health and mother-infant bonding problems: a 20-year prospective cohort study

Psychol Med. 2019 Dec;49(16):2727-2735. doi: 10.1017/S0033291718003689. Epub 2018 Dec 18.

Abstract

Background: Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother-infant bonding problems.

Methods: The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3-9. VIHCS enrolment began in 2006 (when participants were aged 28-29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother-infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.

Results: Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20-29) reported higher levels of perinatal depressive symptoms and mother-infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42-7.39; mother-infant bonding problems adjusted β = 7.51, 95% CI 3.09-11.92]. There was no evidence that self-harm in adolescence (ages 15-17) was associated with either perinatal outcome.

Conclusions: Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother-infant bonding problems.

Keywords: Cohort study; epidemiology; mother–infant bonding; perinatal mental health; self-mutilation..

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Depression / epidemiology
  • Depression / psychology
  • Depression, Postpartum / epidemiology
  • Depression, Postpartum / etiology
  • Depressive Disorder / epidemiology
  • Depressive Disorder / etiology*
  • Female
  • Humans
  • Infant
  • Mother-Child Relations / psychology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Self-Injurious Behavior / epidemiology*
  • Self-Injurious Behavior / psychology*
  • Surveys and Questionnaires
  • Victoria / epidemiology
  • Young Adult