تاثیر افسردگی بعد از زایمان بر پیوند مادر و نوزاد Is the effect of postpartum depression on mother-infant bonding universal?

1. Introduction The effect of maternal depression on infants has been documented for decades in several studies mostly in the Western world (Beeghly et al., 2017; Closa-Monasterolo et al., 2017; Dubber, Reck, Müller, & Gawlik, 2015). Depressed mothers have a difficult time adjusting to motherhood, are less sensitive to their infant cues, resulting in less than optimal attachment to their infants (Miklush & Connelly, 2013; Tietz, Zietlow, & Reck, 2014). Even mild depressive symptoms in the postpartum period can influence mother-infant attachment and child development (Behrendt et al., 2016; Deave, Heron, Evans, & Emond, 2008; Nieto, Lara, & Navarrete, 2017). A negative mother infant relationship in the early years of the infant’s life has long lasting negative consequences emotionally, socially and cognitively (Abdollahi, Etemadinezhad, & Lye, 2016; Choi, Sikkema, Vythilingum, Geerts, & Watt, 2017; Kerstis et al., 2016). One of the objectives of the Healthy People 2020 is to decrease the number of women who experience postpartum depression (PPD) after delivery. Although some countries have reported a decline in the prevalence of PPD in the past decade (Ko, Rockhill, Tong, Morrow, & Farr, 2017), similar declines have not be universal. Prevalence of PPD varies across and within countries from 0 to 15% in some high income countries to 10–60% in low income countries (Gelaye, Rondon, Araya, & Williams, 2016). Unfortunately, few mothers are diagnosed which may lead to chronic depression and a disturbed mother infant relationship. This is especially true for developing countries where mental health remains a stigma and is not covered by most insurance programs or governmental agencies (Gearing et al., 2015). In the Middle East, Chaaya et al. (2002) found a PPD prevalence of 21.3% among 396 Lebanese women while a recent study from Jordan reported a prevalence of 25% in 315 women (Safadi, Abushaikha, & Ahmad, 2016) and in Qatar the prevalence was 17.6% in 1379 women (Burgut, Bener, Ghuloum, & Sheikh, 2013) The detection of PPD and its effect on the mother infant relationship may differ among cultures and is of paramount importance to clinicians in order to provide the necessary referrals and sensitive interventions. Factors noted in previous studies to influence PPD and the mother-infant relationship were assessed in this study and included: age, parity, education, type of delivery, complications during pregnancy, happy with pregnancy, infant’s gender, social support,history of alcohol use and depression and having a sick newborn (Dennis & Ross, 2006; Dubber et al., 2015; Ko et al., 2017).