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Infant Behav Dev. 2018 May;51:15-23. doi: 10.1016/j.infbeh.2018.02.003. Epub 2018 Mar 10.

Is the Effect of Postpartum Depression on Mother-Infant Bonding Universal?

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Azusa Pacific University, 701 E Foothill Blv., Azusa California, 91702. Electronic address:
Obstetrics and Gynecology, America n University of Beirut Medical Center, Beirut, Lebanon.
Associate Professor of Clinical Specialty, Department of Pediatrics, America n University of Beirut Medical Center, Beirut, Lebanon.



Although the negative consequences of maternal depression on infants has been documented in several Western societies, similar studies have not been conducted in Middle-Eastern countries where cultural norms and traditions may differ. The main objective of this study was to determine the risk factors for postpartum depression (PPD) and its relationship to mother -infant bonding in a Lebanese population.


One hundred and fifty participants were administered the Edinburgh Postpartum Depression Scale (EPDS), and the social support scale at 2-3 days postpartum. At 10-12 weeks mother-infant bonding using the Postpartum Bonding Questionnaire (PBQ) and depression using the Beck Inventory (BDI-II) were assessed during a telephone interview.


The prevalence of depression was 19% with an average score of 10.9 ± 6.02 on the EPDS. At 10-12 weeks 2.7% of the whole sample was depressed with an average score of 18.60 ± 16.87 on the BDI-II. Risk factors of PPD on the EPDS were; history of alcohol use, complications during pregnancy, not a good marital relationship, baby admitted to an intensive care unit, history of depression and low social support. Risk factors for impaired bonding were age, history of depression, BDI-II scores above 20 and low social support. The multiple regression analysis found that impaired bonding was associated with older age, history of depression and low social support, which explained 39% of the variance, F = 7.12, p = 0.02.


The prevalence of PPD was higher than previously reported at day 2-3 post-delivery, but lower at 10-12 weeks postpartum. Impaired mother- infant bonding was associated older mothers, history of depression, low social support and BDI-II scores above 20 which should alert practitioner to assessing these factors in post-partum mothers.


Edinburgh postnatal depression scale; Mother-infant bonding; Postpartum depression

[Indexed for MEDLINE]

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