Postnatal depression and the original mother-child relationship: A prospective cohort study

Background: Previous studies assessing the role of early mother-child relationship as a risk factor for postnatal depression have been cross-sectional and/or retrospective in nature. Aims: To examine associations between early mother-child relationship (assessed prospectively and retrospectively) and later risk of postnatal depression. Methods: Dataset from national 1946 birth cohort study; 1137 women at age 51, completed a modified version of the Bromley Postnatal Depression Scale. Results: Compared with women who did not experience maternal separation or recalled moderate to best level of care, women who experienced maternal separation for 3.5 days or more in early childhood and who felt they received a low level of maternal care were at higher risk of postnatal depression (odds ratio (95% CI): 2.4 (1.51-3.79), p=0.001); this relationship was robust to adjustment for current psychological status. Regular enuresis at age of 6 years (2.2 (1.01-4.90), p=0.05), and lack of emotional closeness in current maternal relationship (1.6 (1.01-2.46), p=0.04) were also associated with increased postnatal depression risk. Insufficient evidence was found for a link between other indicators of early behaviour and temperament (anxious, antisocial, or neurotic behaviour) and reported postnatal depression. Limitations: Postnatal depression was assessed retrospectively using self-report, introducing potential bias in recall. Conclusion: Women who experienced early maternal separation and recalled the lowest level of maternal care had a particularly high risk of postnatal depression. In the treatment and management of postnatal depression, the results support health professionals in their consideration of the woman's past and current relationship with her mother; both actual events and the woman's perceptions of them. (C) 2006 Elsevier B.V. All rights reserved.