Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2025; 15(9): 110656
Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.110656
Impact of postpartum persistent depression on infant developmental behavior and maternal self-efficacy
Shu-Juan Wu, Jing-Xian Wang, Xiu-Lei Yin, Ying He, Hui-Xian Kang
Shu-Juan Wu, Xiu-Lei Yin, Ying He, Hui-Xian Kang, Department of Obstetrics, Shijiazhuang Maternal and Child Health Care Hospital, Shijiazhuang 050000, Hebei Province, China
Jing-Xian Wang, Department of Clinical Psychology, Shijiazhuang Maternal and Child Health Care Hospital, Shijiazhuang 050000, Hebei Province, China
Author contributions: Wu SJ contributed to the study design, data collection, initial data analysis, and manuscript drafting; Wang JX participated in the study design, assisted in data collection, conducted part of the statistical analysis, and reviewed the manuscript; Yin XL was involved in study discussions, collected clinical data from some patients, and participated in the interpretation and validation of complex statistical models; He Y contributed to the research design, assisted in data collection and analysis, and managed the project’s daily operations; Kang HX led the overall study design, supervised data analysis, and provided academic guidance throughout the research process.
Supported by the Key Medical Research Project of Hebei Province in 2020, No. 20201360.
Institutional review board statement: This study was approved by the Institutional Review Board of The First Hospital of Jilin University (Approval Number: 20201111). All procedures were conducted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent statement: Informed consent was obtained from all individual participants included in the study. Participants were provided with detailed information about the study's purpose, procedures, potential risks, and benefits. Written informed consent was obtained from each participant prior to their inclusion in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. The data sharing policy adheres to the guidelines set by The First Hospital of Jilin University and complies with relevant data protection regulations.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Xian Kang, Associate Chief Physician, Department of Obstetrics, Shijiazhuang Maternal and Child Health Care Hospital, No. 396 Youyi South Street, Qiaoxi District, Shijiazhuang 050000, Hebei Province, China. 13473406675@163.com
Received: June 13, 2025
Revised: July 9, 2025
Accepted: July 18, 2025
Published online: September 19, 2025
Processing time: 74 Days and 2.6 Hours
Abstract
BACKGROUND

Postpartum depression (PPD) represents a significant public health concern, adversely affecting both new mothers and their infants. Despite routine early screening, PPD can persist beyond the initial postpartum months, with notably high incidence rates even one year after childbirth. Persistent PPD has been associated with poor developmental outcomes in infants, highlighting the need for continued monitoring and support during this critical period. Understanding the broader impacts of persistent PPD is essential for developing effective interventions to improve maternal and infant well-being.

AIM

To explore the impact of persistent PPD on infant developmental behavior and maternal self-efficacy.

METHODS

We recruited 60 postpartum women who experienced persistent depression after childbirth in our hospital from January 2020 to December 2024 as the research subjects. The study collected basic characteristics of both infants and mothers, analyzed the self-efficacy of the mothers and the developmental behaviors of the infants, and conducted a correlation analysis to examine the relationship between postpartum persistent depression in mothers and the developmental behaviors and self-efficacy of infants. The Bootstrap method was used to verify the significance of the mediating effect.

RESULTS

The basic characteristics of infants and mothers show that 53.33% are male, 58.33% are born via vaginal delivery, 88.33% have a normal body mass index, 51.67% are aged between 25 and 29 years, 70% are non-agricultural workers, 51.67% have a per capita household income over 4000 yuan, 96.67% are full-term births, and 58.33% of the fathers are aged between 26 and 32 years. In terms of infant development behavior, the gross motor skills score is relatively low (38.44 ± 12.15). Regarding maternal self-efficacy, the skill score (45.68 ± 5.49) and mental activity score (46.37 ± 3.72) are both at a low level. Correlation analysis reveals that postpartum persistent depression is significantly negatively correlated with maternal self-efficacy and infant development behavior (β = -0.439, -0.657, P < 0.001), while self-efficacy is positively correlated with infant development behavior (β = 0.728, P < 0.001). The path coefficient and Bootstrap method test indicate that self-efficacy acts as a mediator between postpartum persistent depression and infant development behavior, accounting for 54.80% of the effect (P < 0.05), while the direct effect of postpartum persistent depression on infant development behavior is 45.20% (P < 0.05).

CONCLUSION

Persistent PPD significantly negatively impacts infant developmental outcomes, with maternal self-efficacy serving as a partial mediator. These findings suggest that interventions targeting both depressive symptoms and self-enhancement may effectively promote infant health development.

Keywords: Postpartum women; Postpartum; Persistent depression; Baby; Developmental behavior; Self-efficacy

Core Tip: This study investigates the impact of persistent postpartum depression (PPD) on infant developmental behavior and maternal self-efficacy. Utilizing the Edinburgh Postnatal Depression Scale and Ages & Stages Questionnaires, Third Edition, we assessed 60 mother-infant dyads over a five-year period. Our findings reveal that persistent PPD significantly negatively impacts infant developmental outcomes, with maternal self-efficacy partially mediating this relationship. These insights underscore the necessity for targeted interventions addressing both depressive symptoms and enhancement of maternal self-efficacy to foster healthy infant development. This study enriches the understanding of developmental psychopathology and highlights potential targets for early intervention strategies.