Postpartum Depression Is Associated With Altered Neural Connectivity Between Affective and Mentalizing Regions During Mother-Infant Interactions

Judith K Morgan; Hendrik Santosa; Rachel M Fridley; Kaetlyn K Conner; Alison E Hipwell; Erika E Forbes; Theodore J Huppert

doi:10.3389/fgwh.2021.744649

Postpartum Depression Is Associated With Altered Neural Connectivity Between Affective and Mentalizing Regions During Mother-Infant Interactions

Front Glob Womens Health. 2021 Sep 23:2:744649. doi: 10.3389/fgwh.2021.744649. eCollection 2021.

Authors

Judith K Morgan^{1

2}, Hendrik Santosa³, Rachel M Fridley⁴, Kaetlyn K Conner⁴, Alison E Hipwell^{1

2}, Erika E Forbes^{1

2}, Theodore J Huppert⁵

Affiliations

¹ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.
² Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States.
³ Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States.
⁴ University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
⁵ Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA, United States.

Abstract

Although there has been growing interest in mood-related neural alterations in women in the initial weeks postpartum, recent work has demonstrated that postpartum depression often lingers for months or years following birth. However, research evaluating the impact of depression on maternal brain function during mother-infant interactions in the late postpartum period is lacking. The current study tested the hypothesis that depressive symptoms at 12-months postpartum are associated with neural alterations in affective and social neural regions, using near-infrared spectroscopy during in vivo mother-infant interactions. Participants were 23 birth mothers of 12-month-old infants (60% boys). While undergoing near-infrared spectroscopy, mothers engaged in an ecologically valid interactive task in which they looked at an age-appropriate book with their infants. Mothers also reported on their depressive symptoms in the past week and were rated on their observed levels of maternal sensitivity during mother-infant play. Greater depressive severity at 12-months postpartum was related to lower connectivity between the right temporoparietal junction and the lateral prefrontal cortex, but greater connectivity between the right temporoparietal junction and anterior medial prefrontal cortex during mother-infant interaction. Given the putative functions of these neural regions within the maternal brain network, our findings suggest that in the context of depression, postpartum mothers' mentalizing about her infants' thoughts and feelings may be related to lower ability to express and regulate her own emotions, but greater ability to engage in emotional bonding with her infant. Future work should explore how connectivity among these regions is associated with longitudinal changes in maternal behavior, especially in the context of changes in mothers' depressive symptoms (e.g., with treatment) over time.

Keywords: maternal brain network; maternal sensitivity; mentalizing; near infrared spectroscopy; neural connectivity; postpartum depression.