Maternal mental health and its association with pregnancy outcomes and mother–infant bonding among adolescent girls and young women in Kenya

Background Early motherhood and untreated common mental disorders (CMDs) among adolescent girls and young women (AGYW) have been independently associated with adverse child outcomes and impaired maternal‒child interactions. We assessed relationships of depression, general anxiety disorder (GAD) and posttraumatic stress disorder (PTSD) with maternal adjustment, pregnancy outcomes and quality of mother-infant bonding among pregnant and parenting AGYW. Methods We conducted a cross-sectional study nested within the ongoing KEN SHE (KENya single-dose HPV vaccine efficacy) 7-year longitudinal trial in Kisumu, southwestern Kenya. We recruited 270 pregnant and parenting AGYW by convenience sampling. Data were collected via the Maternal Adjustment and Maternal Attitude Scale (MAMAS) and the Postpartum Bonding Questionnaire. Depression, GAD, and PTSD were screened with the PHQ-9, GAD-7, and Harvard Trauma Questionnaire. Participants with moderate-to-severe symptoms on any instrument were classified as CMD positive. Logistic regression, Spearman's rho, and multivariate analysis of variance were used to examine associations. Results Moderate to severe CMD symptoms were present in 22% of the participants. These participants scored significantly lower, indicating poorer adjustment, on all five MAMAS domains (all F(1,268)): attitude toward sex 14.06, p < 0.001; body image 4.61, p = 0.033; somatic symptoms 8.67, p = 0.004; partner relationship 7.62, p = 0.006; attitudes to pregnancy and the baby 18.37, p < 0.001. Depression, GAD, and PTSD symptoms were each associated with more negative feelings toward the infant (rho = 0.31, 0.32, and 0.38, respectively; all p < 0.05). AGYW with CMD symptoms had over three times the odds of an adverse infant outcome (aOR 3.23, 95% CI 1.29–8.04, adjusted for maternal age and marital status). Conclusion CMD symptoms were associated with adverse infant outcomes and poorer maternal-infant bonding. Interventions are needed to support maternal mental health and pregnancy management in the context of AGYW to improve bonding and pregnancy outcomes.