The Relationship between Postpartum Depression in Parents and Infant Growth, Development, and Exclusive Breastfeeding: A Cohort Study in Tehran, Iran

Document Type : Original Article

Authors

1 Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Clinical Psychologist, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Pediatrics, Maternal Pediatric Health Specialist, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

10.22038/ijn.2025.75277.2452

Abstract

Background: Recent research suggests that mood disorders during pregnancy affect both parents, with maternal depression negatively impacting fetal and infant growth. However, few studies have simultaneously explored the influence of maternal and paternal depression on infant development and breastfeeding. This study aimed to concurrently examine the impact of postpartum depression in parents on the process of infant growth and exclusive breastfeeding.
Methods: This cohort study involved 150 couples and their infants at Vali-e-Asr Hospital in Tehran, utilizing convenience sampling. Data were collected via demographic questionnaires, the Beck Depression Inventory (BDI), and the Edinburgh Postnatal Depression Scale (EPDS) at three time points: the last trimester of pregnancy, immediately after childbirth, and 4 weeks postpartum. Infant growth indicators (weight, length, head circumference) were assessed at birth, with weight and exclusive breastfeeding evaluated at 4 weeks and 6 months postpartum.
Results: Maternal depression showed a significant correlation with infant growth indicators and exclusive breastfeeding (P < 0.0001). Paternal depression was significantly associated with infant head circumference at birth (P < 0.001). Logistic regression analyzed the relationship between maternal and paternal depression.
Conclusion: These findings highlight the role of parental postpartum depression in influencing infant growth, development, and breastfeeding. Pre-conception screening and psychological interventions are recommended to prevent these effects.
 

Keywords


  1. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health (Lond). 2019;15:1745506519844044
  2. Essien UR, Molina RL, Lasser KE. Strengthening the postpartum transition of care to address racial disparities in maternal health. J Natl Med Assoc. 2019;111(4):349-351.
  3. Schoretsanitis G, Gastaldon C, Ochsenbein-Koelble N, Olbrich S, Barbui C, Seifritz E. Postpartum hemorrhage and postpartum depression: A systematic review and meta-analysis of observational studies. Acta Psychiatr Scand. 2024; 150(5):274-283. 
  4. Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Affect Disord. 2016; 206:189-203.
  5. Coll CVN, Domingues MR, Stein A, da Silva BGC, Bassani DG, Hartwig FP, et al. Efficacy of regular exercise during pregnancy on the prevention of postpartum depression: The PAMELA randomized clinical trial. JAMA Netw Open. 2019;2(1):e186861.
  6. Di Florio A, Gordon-Smith K, Forty L, Kosorok MR, Fraser C, Perry A, et al. Stratification of the risk of bipolar disorder recurrences in pregnancy and postpartum. Br J Psychiatry. 2018;213(3):542-547.
  7. Simen S, Kuscher K, Schröder L, Yilmaz-Terzioglu N, Schröder T, Jung R, et al. Routine screening for peripartum depression in the gynecologic and pediatric setting - Evaluation of an adapted EPDS version. Z Geburtshilfe Neonatol. 2023;227(3):213-218.
  8. Ramsauer B, Mühlhan C, Mueller J, Schulte-Markwort M. Parenting stress and postpartum depression/anxiety in mothers with personality disorders: indications for differential intervention priorities. Eur Child Adolesc Psychiatry. 2016; 25(6):589-600.
  9. Stuart AC, Stougård M, Smith-Nielsen J, Egmose I, Guedeney A, Vaever MS. Associations between symptoms of maternal postpartum depression, gestational age and infant social withdrawal: A longitudinal study in a community cohort. Br J Dev Psychol. 2022;40(3):371-383. 
  10. Sutter-Dallay AL, Murray L, Dequae-Merchadou L, Glatigny-Dallay E, Bourgeois ML, Verdoux H. A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development. Eur Psychiatry. 2011; 26(8):484-489.
  11. Mikšić Š, Uglešić B, Jakab J, Holik D, Milostić Srb A, Degmečić D. Positive effect of breastfeeding on child development, anxiety, and postpartum depression. Int J Environ Res Public Health. 2020;17(8):2725.
  12. Hoffman MC, Mazzoni SE, Wagner BD, Laudenslager ML, Ross RG. Measures of maternal stress and mood in relation to pretermbirth. Obstet Gynecol. 2016;127(3):545-552.
  13. Masoumeh Kashkouli1, Saeideh Ziaei. The relationship between breastfeeding and Postpartum Depression in women referring to health centers in Darreh Shahr County, Ilam Province. J Sabzevar Univ Med Sci. 2020;27(2):268-273.
  14. Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J). 2013;89(4):332-338.
  15. Hamidi R, Fekrizadeh Z, Azadbakht M, Garmaroudi G, Taheri Tanjani P, Fathizadeh S, et al. Validity and reliability Beck Depression Inventory-II among the Iranian elderly Population. J Sabzevar Univ Med Sci. 2015;22(1):189-198.
  16. Ahmadi Kani Golzar A, Golizadeh Z. Validation of Edinburgh Postpartum Depression Scale (EPDS) for screening postpartum depression in Iran. IJPN. 2015;3(3):1-10.
  17. Kerstis B, Engström G, Edlund B, Aarts C. Association between mothers' and fathers' depressive symptoms, sense of coherence and perception of their child's temperament in early parenthood in Sweden. Scand J Public Health. 2013;41(3):233-239.
  18. Pinto TM, Caldas F, Nogueira-Silva C, Figueiredo B. Maternal depression and anxiety and fetal-neonatal growth. J Pediatr (Rio J). 2017;93(5):452-459.
  19. Diez-Sampedro A, Flowers M, Olenick M, Maltseva T, Valdes G. Women's choice regarding breastfeeding and its effect on well-being. Nurs Womens Health. 2019;23(5):383-389. 
  20. Aoyagi SS, Tsuchiya KJ. Does maternal postpartum depression affect children's developmental outcomes? J Obstet Gynaecol Res. 2019;45(9):1809-1820.