Assessing Parent-Infant Bonding in a Community Perinatal Mental Health Service

Perinatal mental health (PMH) services support the mental health needs of women and birthing people in pregnancy and postnatal, alongside the developing relationship between parent and infant. Mental health symptoms in PMH services are routinely screened for, yet there are inconsistencies in whether parent-infant bond is assessed and how. The aim of this study is to assess the predictive validity of screening for parent-infant bonding difficulties (Postpartum Bonding Questionnaire (PBQ)) and psychopathology (CORE-10) to predict patient outcomes at discharge from a PMH service.

Secondary analysis of clinical data from a PMH service in Birmingham, United Kingdom, encompassed 948 patient records. A structural equation model was constructed on patient data containing PBQ and CORE-10 scores recorded at initial assessment and discharge from the service.

Analysis revealed a significant decrease in bonding difficulties and psychopathology scores from initial assessment to discharge from the service. The predictive model showed CORE-10 scores at discharge were predicted by both initial CORE-10 and PBQ scores, whereas PBQ scores at discharge were predicted solely by initial PBQ scores. Demographic factors including age, parity and ethnicity did not present any direct association with psychopathology or bonding difficulties at either timepoint.

This analysis provides evidence of a pathway between early parent-infant bond and later psychopathology symptoms, which exists independently from the pathway between psychopathology symptoms at intake and discharge alone. These findings support embedding self-report assessments of parent-infant bond, in addition to measures of psychopathology, to better predict patient outcomes at discharge from a PMH service.