Maternal Mental Health, Emotion Regulation and Caesarean Section Delivery: Associations with Infant Development in a Sample Accessing Perinatal Mental Health Services

Background: Maternal mental health difficulties are a risk factor for poorer child development. Various factors are believed to contribute to this relationship, though there are substantial gaps in the literature. Furthermore, diagnostic approaches in mental health fail to adequately capture and address the complexities and nuances associated with perinatal mental health.

Aims: This study explores the relationship between moderate-to-severe perinatal mental health difficulties and infant development through the lens of social inequality and reproductive justice. Specifically, this study examines the role of transdiagnostic factors including emotion regulation (ER), birth mode, deprivation and marginalisation.

Participants: Data was taken from 352 mother-infant dyads participating in the COSI trial (Rosan et al., 2023). All mothers were accessing perinatal mental health services in the UK at the time of participation.

Methods: Data from baseline self-report questionnaires were analysed using correlational analyses, mediation analysis and moderated mediation analysis.

Results: Maternal psychological distress and difficulties in ER were associated with poorer infant social-emotional development. Furthermore, maternal ER mediated the relationship between severity of psychological distress and poorer social-emotional and global development. Mode of birth was not significantly associated with infant developmental outcomes in this sample. Despite low levels of marginalised identity characteristics (minoritised ethnicity, sexuality, gender identity) within the sample relative to the wider population, both deprivation and marginalisation demonstrated significant relationships with perinatal mental health difficulties. Furthermore deprivation was associated with poorer global infant development.

Conclusion: This study highlights the importance of transdiagnostic factors associated with social inequality on perinatal mental health and infant development. Implications for further research, clinical practice and policy are explored.