Mother-infant interaction and infant development in women at risk of postpartum psychosis with and without a postpartum relapse

• Published in: Psychological medicine 2024-03, Vol.54 (4), p.823-834
• Main Authors: Biaggi, Alessandra, Hazelgrove, Katie, Waites, Freddie, Bind, Rebecca H, Lawrence, Andrew J, Fuste, Montserrat, Conroy, Susan, Howard, Louise M, Mehta, Mitul A, Miele, Maddalena, Seneviratne, Gertrude, Pawlby, Susan, Pariante, Carmine M, Dazzan, Paola
• Format: Article
• Language: English
• Subjects: At risk populations; Babies; Bipolar disorder; Cognitive ability; Cognitive development; Emotional development; Emotions; Family medical history; Infants; Language; Language acquisition; Medical diagnosis; Mental depression; Mental disorders; Mother-infant relations; Mother-offspring interactions; Motor development; Obstetrics; Population; Postpartum; Postpartum period; Postpartum women; Pregnancy; Psychosis; Relapse; Schizoaffective disorder; Schizophrenia; Sociodemographics; Synchrony; Womens health
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291723002568

This study aimed to investigate mother-infant interaction and infant development in women at-risk of postpartum psychosis (PP), with and without a postpartum relapse. 103 women (and their offspring) were included, 43 at-risk-of-PP because of a diagnosis of bipolar disorder, schizoaffective disorder or previous PP, and 60 with no current/previous mental illness or family history of PP. Of the at-risk women, 18 developed a psychiatric relapse within 4 weeks after delivery (AR-unwell), while 25 remained symptom-free (AR-well). Mother-infant interaction was assessed using the CARE-Index at 8 weeks' and 12 months' postpartum and infant development using the Bayley-III at 12 months' postpartum. Women at-risk-of-PP as a group, regardless of whether they developed a psychiatric relapse within 4 weeks after delivery, had less synchronous mother-infant interactions and had infants with less optimal cognitive, language, motor and socio-emotional development than healthy controls. In particular, boys of at-risk women had the lowest scores in cognitive, language and motor development and in mother-infant interaction, while girls of the at-risk women had the lowest scores in socio-emotional development. The synchrony in the dyad predicted infant cognitive and language development. There was no evidence for a difference in mother-infant interaction nor in infant development between the AR-unwell and AR-well groups. These results suggest that, while there is a lack of evidence that an early postpartum relapse in women at-risk-of-PP could represent a risk for the infant , maternal risk for PP may be associated with less optimal mother-infant interaction and infant development.