Antenatal and postnatal association of maternal bonding and mental health in Fukushima after the Great East Japan Earthquake of 2011:The Japan Environment and Children's Study (JECS)

Background: Japan Environmental and Children's Study (JECS) was under way in Fukushima at the time of the triple disaster. It was initially to assess the effects of environmental factors on children's health, but given the situation particular to the accident, it could also offer an additional source of material with which to examine the psychological impacts of the disaster on mothers. This study aimed to examine the characteristics of mental health of Fukushima mothers after the triple disaster by comparing the scores in Fukushima with the nationwide scores. Then, it aimed to examine associations between their maternal bonding and mental health both during pregnancy and following birth. Methods: The JECS administered the Kessler 6-item psychological distress scale (K6) during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) 1 month following birth to 97 454 eligible women. In conjunction with the JECS, this study analysed the scores of 11 630 women in Fukushima which were obtained in the JECS between 2011 and 2015, and compared them with the nationwide scores during the same time period. Results: The proportion of mothers having 'negative feelings toward pregnancy' was significantly higher in Fukushima Regional centre (RC) than in the other 13 RCs between 2011 and 2014. No significant difference in the 'lack of affection' scores following birth was found between Fukushima RC and other RCs in 2012 and 2013, but the score in Fukushima RC was significantly lower in 2014 and 2015. The K6 scores in Fukushima RC were significantly higher than in other RCs in all years, and the EPDS scores following birth in Fukushima RC were also higher than in the 13 RCs in all years. The results of multivariate analysis showed a significant association between 'mothers' negative feelings toward pregnancy' and depressive symptoms, except in Fukushima RC in 2011. Also, it showed another significant association between 'lack of affection' and postpartum depressive symptoms from 2012 to 2015 in both Fukushima RC and 13 RCs. K6 scores during pregnancy were significantly associated with EPDS scores throughout the study period in both Fukushima RC and 13 RCs. Limitations: Due to the lack of information on participants' residential region at the municipal level in the JECS, it was unable to measure regional differences within Fukushima prefecture. Conclusion: This study shed light on the relationship between maternal bonding and mental health both during pregnancy and following birth by using the sequential and periodic national data sets. While showing the maternal characteristics associated with depressive symptoms during pregnancy and following birth in Japan, it distinguished the characteristics between Fukushima and nationwide. It raised the possibility that providing mothers in Fukushima with supports to increase their bonding toward their pregnancy could prevent the development of depressive tendency. The results could suggest that not only depression prevention measures but also maternal bonding support could be necessary in the region.

Automated summary

The study examined the mental health of Fukushima mothers after the triple disaster compared to nationwide scores, showing a higher proportion of negative feelings towards pregnancy and lower lack of affection scores following birth in Fukushima. The study also found significantly higher K6 and EPDS scores in Fukushima, as well as associations between negative feelings towards pregnancy and depressive symptoms, and lack of affection and postpartum depressive symptoms in both Fukushima and nationwide. The results suggest that supporting maternal bonding during pregnancy in Fukushima could help prevent depressive tendencies.