Maternal attitude and mental health during pregnancy and after childbirth as factors of postpartum depression

Background: The prevalence of postpartum depressive experiences and their negative impact on mother–child dyad interactions in the short and long term necessitates an examination of pre- and postnatal factors of postpartum depression. Aim: The aim of this study was to examine maternal mental health characteristics and attitudes toward the child during pregnancy and after childbirth as predictors of postpartum depressive experiences. Methods: This longitudinal study included 430 pregnant women, 105 of whom were interviewed 4–8 months after childbirth. The following instruments were used: the Achenbach System of Empirically Based Assessment (ASEBA); the Pregnant Women’s Attitude Test; the Maternal Attitude Test; the Maternal Antenatal and Postnatal Attachment Scales; and the socio-demographic questionnaire. Results: 18.1% of pregnant women showed signs of depressive disorders (11.3% were at risk, 6.8% had clinical manifestations). The severity of depression was higher in women in unregistered marriages (p = 0.026), in cases of unplanned pregnancy (p = 0.000), and in women who had been raised in a single-parent family (p = 0.013). In the postnatal period, 15.4% of women were at risk, and 3.9% had a clinical level of depressive disorder. Regression analysis revealed a significant combined effect (R2 = 0.426) of depressive disorder (β = 0.419, p 0.01) and avoidance disorders (β = 0.337, p 0.05) during pregnancy on the severity of maternal depressive experiences in the first year of the child’s life. In the postnatal period, depression was predicted by withdrawal syndrome (R2 = 0.54; β = 0.735, p 0.001), depressive attitudes towards motherhood and child (β = 0.413, p 0.001), and the quality of postnatal attachment (β = –0.320, p 0.01). Conclusion: The prevalence and identified pre- and postnatal predictors of postpartum depressive disorders confirm the importance of joint monitoring of women by physicians and psychologists from the very moment of pregnancy, the significance of developing a social support network, and a positive attitude towards motherhood and child.