Associations between birth-related stressors, social reward responsiveness, and postpartum internalizing symptoms

Birth-related stressors and reward processing are associated with postpartum internalizing symptoms. We examined main effects and interactions of reward processing and birth-related stressors on postpartum internalizing symptoms.

Cross-sectional.

Women (n = 95) completed the Birth Experience Interview and questionnaires at 8-weeks postpartum. In addition, while electroencephalogram (EEG) data were collected, participants completed a Social Incentive Delay task to measure neural responses to feedback indicating a correct response and receipt of a social reward (photo of own infant) vs. feedback indicating an incorrect response and neutral outcome. EEG analyses focused on reward positivity (RewP) to reward feedback, adjusting for responses to neutral feedback. Participants completed questionnaires on depressive, anxiety, and traumatic intrusion symptoms.

Greater birth-related severity and violations of expectations during childbirth were associated with more traumatic intrusion symptoms, but not depressive or anxiety symptoms. Surprisingly, an enhanced social RewP was associated with greater depression and anxiety symptoms. Social RewP moderated associations between birth experiences and postpartum traumatic intrusions; greater violation of expectations was associated with greater traumatic intrusions for those with relatively larger social RewP.

Results support the utility of using dimensions of birth-related stressors as well as ERPs for measuring individual differences in reward processing relevant to postpartum internalizing symptoms.