The relationship between maternal depression and mother-infant bonding

Aim:In the context of primary care, where family physicians address health problems through a biopsychosocial approach, it is crucial to identify risk factors that may adversely affect maternal bonding within the community they serve. Such factors can potentially compromise the infant's relationship not only with the mother but also with others in their environment. Understanding these influences is essential for delivering effective, high-quality, and holistic healthcare services. This study aims to examine the social and psychological determinants that impact mother-infant bonding. The findings are expected to enhance the quality of follow-up and intervention practices in primary healthcare settings and contribute positively to both maternal and infant well-being. Materials and Methods: The study was carried out between October 1 and December 31, 2024, with the participation of 21 out of 33 family health centers and 70 out of 100 family medicine units in the city center of Çorum. A total of 86 mothers, who had given birth within the past 0–6 weeks, were literate, volunteered to participate, and were able to use a smartphone, were included in the study. After collecting sociodemographic data, participants were asked to complete the Maternal Attachment Inventory and the Edinburgh Postnatal Depression Scale, both of which have been validated for use in Turkish, via Google Forms. Results: In terms of educational background, 1.16% of participants had completed primary school, 12.79% middle school, 40.7% high school, 39.53% university, and 5.81% held a postgraduate degree. Regarding occupational status, 11.63% were unemployed, 50% were housewives, 30.23% were public servants, and 8.14% were self-employed.In terms of income, 24.42% reported that their income was less than their expenses, 53.49% stated it was balanced, and 22.09% reported having an income higher than their expenses. A total of 17.44% of participants had a history of stillbirth or giving birth to a child with disabilities, while 82.56% had not experienced such outcomes. The majority (98.84%) reported that their current baby was healthy.The most recent pregnancy was planned in 88.37% of cases, and 23.26% were considered high-risk pregnancies. About 46.51% of participants reported having someone to assist with infant care at home. Prior to pregnancy, 4.65% had been diagnosed with a psychiatric disorder, and 1.16% reported using psychiatric medication. A total of 36.05% experienced job loss or economic changes due to the pregnancy. The mean score on the Maternal Attachment Inventory (MAI) was 4.36 (±3.21), with a median score of 4 (range: 0–16). The mean score on the Edinburgh Postnatal Depression Scale (EPDS) was 11.48 (±6.76), with a median score of 10 (range: 0–28). According to EPDS results, 65.12% of participants were not at risk for depression, while 34.88% were identified as being at risk.EPDS scores were found to be significantly higher among employed participants compared to housewives, and among those with education above high school compared to those with lower educational levels (p<0.05). Participants whose income was either below or above their expenses had significantly higher EPDS scores compared to those whose income and expenses were balanced (p<0.01).EPDS scores were also significantly higher among participants whose most recent pregnancy was unplanned, those with high-risk pregnancies, those without support for infant care at home, and those who experienced job loss or economic hardship due to pregnancy (p<0.05).MAI scores were significantly higher among employed mothers compared to housewives, and among those whose monthly income exceeded their expenses compared to those whose income was equal to or less than their expenses (p<0.05). Additionally, mothers whose most recent pregnancy was unplanned or considered high-risk had significantly higher MAI scores compared to those with planned or low-risk pregnancies (p<0.05). Conclusions: Through our study conducted within family medicine units operating at the primary healthcare level, various social and psychological factors that may influence the bonding between mother and infant have been identified. Postpartum depression, anxiety, and past traumas can reduce a mother's sensitivity and her capacity to provide adequate care for her infant. Maternal psychological well-being, social support systems, the infant's health status, economic conditions, and cultural dynamics all play a critical role in establishing secure attachment. Therefore, developing comprehensive support mechanisms is essential to facilitate a healthy mother-infant relationship. The findings are expected to contribute positively to maternal and infant health by enhancing the quality of follow-up processes in primary care, strengthening mother-infant bonding, and promoting a holistic approach to care. Keywords: Maternal-infant bonding, Depression, family medicine, Primary healthcare services