Gastrointestinal Symptoms in Infants of Mothers with a Psychiatric History and the Role of Depression and Bonding

Abstract

Gastroesophageal reflux (GER), excessive crying, and constipation are common gastrointestinal symptoms in infancy of multifactorial origin in which psychosocial stress factors play an important role. The aims of this observational study were to investigate the presence of gastrointestinal symptoms in infants of mothers with or without a history of a psychiatric disorder, their association with maternal depressive symptoms, and the possible mediating role of bonding.Methods:One hundred one mothers with a history of a psychiatric disorder and 60 control mothers were included. Infant gastrointestinal symptoms, maternal depressive symptoms, and mother-infant bonding were assessed using validated questionnaires and diagnostic criteria at 1.5 months postpartum.Results:The mean total score on the Infant Gastroesophageal Reflux Questionnaire Revised reported in infants of mothers with psychiatric disorder (13.4 standard deviation 5.4) was significantly higher than that in infants of control mothers (10.8 standard deviation 5.4; P=.003). No significant differences were found in the presence of excessive crying (modified Wessel criteria and subjective experience) and constipation (Rome IV criteria) between both groups. Infant GER was associated with maternal depressive symptoms (P=0.027) and bonding problems (P=<0.001). Constipation was related to maternal depressive symptoms (P=0.045), and excessive crying (Wessel and subjective criteria) was associated with bonding problems (P=0.022 and P=0.002, respectively). The effect of maternal depressive symptomatology on infant GER symptoms and excessive crying was mediated by bonding problems.Conclusion:Maternal psychiatric history is associated with infant gastrointestinal symptoms, in which mother-infant bonding is a mediating factor.