Postpartum thoughts of infant-related harm, OCD unrelated to risk of maternal aggression

Postpartum unwanted intrusive thoughts based on intentional infant-related harm or obsessive-compulsive disorder were not associated with elevated risk of harm to infants, according to a study published in the Journal of Clinical Psychiatry.

“UITs of infant-related harm are a core feature of postpartum OCD,” Nichole Fairbrother, PhD, assistant professor of psychiatry at the University of British Columbia, and colleagues wrote.

“Further, although it is widely accepted that OCD is not associated with an increased risk of violence and that sufferers are not at risk of acting on the content of their obsessions, this assertion has not been formally assessed.”

Researchers sought to evaluate the connection between new mothers' UITs of intentional harm and OCD with maternal aggression toward their infants, and to document the prevalence of the same.

It is estimated that 1 in 4 American children suffer from some form of maltreatment, the authors note. Referrals to child protective services suggest a prevalence rate of 9 per 1,000 cases.

The study drew from a prospective, province-wide sample of 763 English-speaking women who had just given birth and were aged 19 years and older. A total of 388 participants responded. Study enrollees completed two questionnaires and interviews postpartum to gauge incidence of UITs of infant-related harm, OCD (based on DSM-5 criteria), and maternal aggression toward their infant. Data were collected from February 2014 to February 2017.

Fairbrother and colleagues found 2.9% (95% CI, 1.5% to 4.7%) of participants (n = 11) reported non-ideated aggressive behavior toward their child. The estimated prevalence of experiencing UITs within the first 9 months postpartum was 44.4% (95% CI, 32.9% to 49.7%).

Mothers who reported UITs of intentional, infant-related harm were not more likely to report aggression toward their newborn compared with women who did not report this ideation. The same held true for women with and without OCD.

“The findings from this study provide critical and reassuring information regarding the relation between new mothers’ UITs of intentional harm and the risk of violence toward the infant,” the researchers wrote.