Mother and infant outcomes in women with bipolar disorder: Identifying the neonatal behaviours that can be targeted by an intervention to optimise long term mother and child outcomes.

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Maternal mental illness, such as depression, bipolar disorder, and psychosis during pregnancy and the postnatal period can have a negative influence on both the woman and her infant, including the mother-infant relationship and infant development. 

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Given the potential impact of maternal mental illness on the mother and child, it is important to establish early interventions that can support the ther-infant relationship and improve long-term outcomes. The Neonatal Behavioral Assessment Scale (NBAS) and the Newborn Behavioral Observations (NBO) System are two such early interventions that focus on supporting the mother-infant relationship and, in doing so, promote long-term infant development. Previous research has shown these interventions to have been successfully used with women experiencing depression in pregnancy and the postnatal period. However, research is now needed to understand if they are also effective in supporting women with severe mental health problems, such as bipolar disorder or schizoaffective disorder. These women are a particularly vulnerable group, as they are at greatly increased risk of developing an episode of postpartum psychosis, the most severe postnatal mental health problem. Postpartum psychosis is so severe that it usually requires hospital admission and, as a consequence, it can cause additional disruption to the mother-infant relationship, with more negative outcomes for mother and child. 

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In order to develop such an intervention, it is first important to understand the link between newborn behaviour and later mother and child outcomes in this group of women. In particular, we need to understand if there are specific newborn behaviours (such as the ability to follow faces and voices) that could help us develop an intervention based on the NBAS or NBO that could support women with severe mental health problems and at risk of experiencing an episode of postpartum psychosis. 

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To do this, our project aims to follow-up a group of women and their children, who previously participated in a study examining maternal mental health during pregnancy and, with their newborns, in the first 12 months after giving birth. We propose to follow-up these women and their children now aged 6-8 years, to understand 1) what the relationship is between newborn behaviour and mother-child relationship and child outcomes at 6 to 8 years of age, and 2) which specific newborn behaviours are linked to the mother-child relationship and child outcomes that could inform the development of an intervention using the NBAS or NBO to support these women and their children in the long term.

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