The effects of pandemic-specific stress on postpartum bonding: a cross-sectional study

Background Early mother–infant bonding is crucial for maternal well-being and child development and is sensitive to psychological, perinatal, and contextual stressors. Maternal psychological distress and perinatal factors such as gestational age and birth weight have been linked to bonding difficulties, commonly assessed using the Postpartum Bonding Questionnaire (PBQ). The COVID-19 pandemic introduced substantial psychosocial stress, including reduced social support and altered perinatal care, which may have further compromised early bonding. This study investigates if pandemic-related stress negatively impacts postpartum bonding outcomes, with a particular focus on vulnerable groups. Methods Between 2022 and 2023, 47 children aged 6–42 months (median age: 25.3 months), including a high proportion of preterm-born infants (72.3%), were assessed. Mother–infant bonding was measured using the 16-item Postpartum Bonding Questionnaire (PBQ-16). Pandemic-related stress was quantified using a composite Corona Index derived from a standardized parental questionnaire assessing perceived restrictions and burdens during pregnancy, childbirth, and early family life. Parental psychological distress was assessed using the Global Severity Index (GSI) of the Symptom Checklist-90. Multiple linear regression analyses were conducted to examine the associations of parental psychological distress, pandemic-related stress, gestational age, and birth weight with bonding outcomes across the three PBQ subscales. Results Parental psychological distress was the strongest predictor of postpartum bonding difficulties and was significantly associated with impaired bonding across PBQ Scales 1 and 2. Pandemic-related stress independently predicted impaired bonding on PBQ Scale 1. Neonatal factors displayed a differentiated pattern: lower birth weight was associated with increased rejection and pathological anger (PBQ Scale 2), while gestational age predicted infant-focused anxiety (PBQ Scale 3). Descriptively, most mothers reported moderate to severe pandemic-related burden, including pronounced restrictions during pregnancy and childbirth, reduced access to family support services, severe limitations in social contacts, and prolonged periods of stress lasting several months or longer. Conclusion The findings support the hypothesis that pandemic-related stress constitutes a relevant risk factor for impaired postpartum bonding. Pandemic-related social disconnection and prolonged psychosocial burden impaired postpartum bonding, whereas bonding dimensions such as rejection, pathological anger, and infant-focused anxiety are increasingly shaped by psychological and perinatal influences.