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Pre-conception self-harm, maternal mental health and mother–infant bonding problems: a 20-year prospective cohort study

Published online by Cambridge University Press:  18 December 2018

Rohan Borschmann [Opens in a new window] ,
Emma Molyneaux ,
Elizabeth Spry ,
Paul Moran ,
Louise M. Howard ,
Jacqui A. Macdonald ,
Stephanie J. Brown ,
Margarita Moreno-Betancur ,
Craig A. Olsson  and
George C. Patton
Rohan Borschmann
Affiliation:
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia Department of Psychiatry, The University of Melbourne, Melbourne, Australia Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK South London and Maudsley NHS Foundation Trust, London, UK
Emma Molyneaux
Affiliation:
Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
Elizabeth Spry
Affiliation:
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
Paul Moran
Affiliation:
Centre for Academic Mental Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
Louise M. Howard
Affiliation:
Section for Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK South London and Maudsley NHS Foundation Trust, London, UK
Jacqui A. Macdonald
Affiliation:
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
Stephanie J. Brown
Affiliation:
Healthy Mothers Healthy Families, Murdoch Children's Research Institute, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Melbourne, Australia
Margarita Moreno-Betancur
Affiliation:
Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia Centre for Epidemiology and Biostatistics, Melbourne School of Population of Global Health, The University of Melbourne, Melbourne, Australia
Craig A. Olsson
Affiliation:
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia Department of Paediatrics, The University of Melbourne, Melbourne, Australia
George C. Patton
Affiliation:
Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Melbourne, Australia
Corresponding
E-mail address:
emma.molyneaux@kcl.ac.uk
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Abstract

Background

Self-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.

Methods

The Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.

Results

Five hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.

Conclusions

Self-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.

Keywords

Cohort study epidemiology mother–infant bonding perinatal mental health self-mutilation.
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 16 , December 2019 , pp. 2727 - 2735
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

Joint first authors.

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