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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Postpartum Depressive Symptoms and Mother–Infant Bonding at 4–24 Weeks Postpartum: A Cross-Sectional Study of Psychosocial and Breastfeeding-Related Factors

  • Elif Küçük1
  • Mehmet Tolga Köle2
  • Deniz Güven2
  • Seval Öztürk2
  • İbrahim Kandemir3
  • Ezgi Özserezli4
  • Feride Uysal5
  • Burak Ersak6
  • Selvihan Yılmaz Özdemir2
  • Emel Örün2
6 affiliations
  1. 1Department of Psychiatry, Faculty of Medicine, Yüksek İhtisas University, 06530 Ankara, Türkiye
  2. 2Department of Pediatrics, Etlik City Hospital, 06170 Ankara, Türkiye
  3. 3Department of Pediatrics, Istanbul Health and Technology University, 34445 İstanbul, Türkiye
  4. 4Department of Psychiatry, Etlik City Hospital, 06170 Ankara, Türkiye
  5. 5Department of Psychiatry, Kartal Dr. Lutfi Kirdar City Hospital, 34865 İstanbul, Türkiye
  6. 6Department of Gynecologic Oncology, Etlik City Hospital, 06170 Ankara, Türkiye
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Abstract

Background/Objectives: Postpartum depressive symptoms have been associated with maternal functioning and mother–infant bonding (MIB). This study primarily examined the association between postpartum depressive symptom severity and MIB, estimated the proportion screening positive for probable postpartum depression (PPD), and explored relevant sociodemographic and psychosocial correlates. Methods: In this cross-sectional study, 212 mothers assessed at 4–24 weeks postpartum during April–June 2025 completed the Edinburgh Postnatal Depression Scale (EPDS) and Maternal Attachment Inventory (MAI). The primary adjusted analysis used linear regression with HC3 robust standard errors, including infant age and selected clinical and psychosocial covariates. Because 39.2% of MAI scores were at the maximum, Tobit, fractional-logit, and ordinal regressions were used as complementary sensitivity analyses, alongside exploratory spline assessments. Results: Forty-one mothers (19.3%) screened positive for probable PPD (EPDS ≥13). Each 1-point higher EPDS score was associated with a 0.20-point lower MAI score (95% CI: −0.26 to −0.15), approximately one MAI point per five EPDS points. Observed-scale estimates were similar across linear, Tobit, and fractional-logit models, although exploratory splines suggested possible nonlinearity at sparsely represented EPDS extremes. In exploratory adjusted analyses, stressful breastfeeding and nonbreastfeeding were associated with higher EPDS scores. Separately, only four of 69 unadjusted exploratory comparisons survived false-discovery-rate correction, all involving probable PPD screening status and breastfeeding or spousal support. Conclusions: Greater depressive symptom severity was associated with lower bonding scores, but the absolute difference was small and its clinical significance uncertain. The cross-sectional design precludes causal inference.

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Cite

BibTeXRIS
BibTeX
@article{kucuk2026postpartum,
  title = {{Postpartum Depressive Symptoms and Mother–Infant Bonding at 4–24 Weeks Postpartum: A Cross-Sectional Study of Psychosocial and Breastfeeding-Related Factors}},
  author = {Elif Küçük and Mehmet Tolga Köle and Deniz Güven and Seval Öztürk and İbrahim Kandemir and Ezgi Özserezli and Feride Uysal and Burak Ersak and Selvihan Yılmaz Özdemir and Emel Örün},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218677},
  url = {https://www.mdpi.com/2077-0383/15/21/8677},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Postpartum Depressive Symptoms and Mother–Infant Bonding at 4–24 Weeks Postpartum: A Cross-Sectional Study of Psychosocial and Breastfeeding-Related Factors
AU  - Elif Küçük
AU  - Mehmet Tolga Köle
AU  - Deniz Güven
AU  - Seval Öztürk
AU  - İbrahim Kandemir
AU  - Ezgi Özserezli
AU  - Feride Uysal
AU  - Burak Ersak
AU  - Selvihan Yılmaz Özdemir
AU  - Emel Örün
PY  - 2026
DA  - 2026/11/06
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218677
UR  - https://www.mdpi.com/2077-0383/15/21/8677
AB  - Background/Objectives: Postpartum depressive symptoms have been associated with maternal functioning and mother–infant bonding (MIB). This study primarily examined the association between postpartum depressive symptom severity and MIB, estimated the proportion screening positive for probable postpartum depression (PPD), and explored relevant sociodemographic and psychosocial correlates. Methods: In this cross-sectional study, 212 mothers assessed at 4–24 weeks postpartum during April–June 2025 completed the Edinburgh Postnatal Depression Scale (EPDS) and Maternal Attachment Inventory (MAI). The primary adjusted analysis used linear regression with HC3 robust standard errors, including infant age and selected clinical and psychosocial covariates. Because 39.2% of MAI scores were at the maximum, Tobit, fractional-logit, and ordinal regressions were used as complementary sensitivity analyses, alongside exploratory spline assessments. Results: Forty-one mothers (19.3%) screened positive for probable PPD (EPDS ≥13). Each 1-point higher EPDS score was associated with a 0.20-point lower MAI score (95% CI: −0.26 to −0.15), approximately one MAI point per five EPDS points. Observed-scale estimates were similar across linear, Tobit, and fractional-logit models, although exploratory splines suggested possible nonlinearity at sparsely represented EPDS extremes. In exploratory adjusted analyses, stressful breastfeeding and nonbreastfeeding were associated with higher EPDS scores. Separately, only four of 69 unadjusted exploratory comparisons survived false-discovery-rate correction, all involving probable PPD screening status and breastfeeding or spousal support. Conclusions: Greater depressive symptom severity was associated with lower bonding scores, but the absolute difference was small and its clinical significance uncertain. The cross-sectional design precludes causal inference.
SN  - 2077-0383
ER  -