Postpartum Depression and the Emerging Mother-Infant Relationship: Associations With Selective Serotonin Reuptake Inhibitor Medication Use.

Objective: Postpartum depression (PPD) is a major mental health issue and affects up to 1 in 5 women with significant downstream consequences for cognitive and social-emotional health of children. Effective treatments for PPD exist but are not always accessible or acceptable to new mothers. One such treatment is selective serotonin reuptake inhibitors (SSRIs). This study investigated the role of SSRI medication use in the developing mother-infant relationship. Method: Participants were enrolled in this longitudinal study when their infants were 2 to 6 months old. Of the 67 mothers included in the sample, 25 were healthy controls, 25 were diagnosed with PPD and chose not to initiate SSRI treatment, and 17 were diagnosed with PPD and chose to take an SSRI. Self-report measures of depression, parenting-related stress, and bonding; an observational measure of mother-infant interaction quality; and salivary oxytocin were collected across 2 visits spaced 3 months apart. Results: Although depression symptoms decreased across both PPD groups from visit 1 to visit 2, mothers in the SSRI group reported greater improvements in the quality of their relationship with their infant. Ratings of observed maternal sensitivity and dyadic interaction quality were consistently high across groups and ages. However, infants of mothers with PPD did not show expected gains in observed social engagement over this period. Conclusion: Our results, though preliminary, suggest that SSRI use is associated with improvements in perceived mother-infant relationship quality, above and beyond what is explained by depression symptoms. However, potential impacts of maternal depression on infant social development remain.