# Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development

> **NIH NIH R21** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $210,000

## Abstract

PROJECT SUMMARY. Maternal bonding is the basis for secure attachment in the child, stimulating protection
and nurturing crucial for the child’s socioemotional development. Failure to achieve bonding in the early
postpartum period can result in adverse developmental problems in the child with heavy societal costs. Many
women suffering from postpartum psychopathology exhibit poor maternal bonding, which, at its extreme, may
lead to child abuse and neglect, the prevention of which is a stated NICHD mission. Understanding the underlying
neural mechanism mediating postpartum maternal bonding impairment is crucial to achieve prevention. We
propose to use quantitative neuroimaging approaches to determine the neural basis of maternal response to a
child related stressor and how this is altered in the context of postpartum psychopathology. Recent and limited
neuroimaging studies focused largely on postpartum maternal bonding in the context of postpartum depression
with other conditions largely overlooked. One such disorder is childbirth-related posttraumatic stress disorder
(CB-PTSD). CB-PTSD symptoms have been reported in up to 25% of mothers with the acute symptoms induced
by birth related traumatic events including near-death experience. To date, there is very limited understanding
of the biological and neural basis of CB-PTSD. In this study we will implement a valid protocol to determine the
altered neural activity in mothers with CB-PTSD using functional neuroimaging. Commencing in the hours
following parturition, we will identify 60 women at risk for CB-PTSD who will be assessed in the early postpartum
for CB-PTSD symptoms and neural activation as visualized by fMRI evoked by infant cry and distressed facial
expression. Neural activations will be correlated with maternal bonding measurements and collected child
developmental scores. Maternal CB-PTSD will be measured with psycho-diagnostics and psychometrics;
maternal bonding will be quantified by psychometrics and observational assessment of the bonding behavior;
and child development via standardized observational methods. We expect our findings will advance scientific
knowledge of the neural correlates mediating impairments in maternal bonding in women suffering from
postpartum psychopathology. Identification of novel neural markers of maternal impairments in CB-PTSD in the
very early postpartum could help distinguish CB-PTSD from other postpartum pathologies and encourage
specialized psychological interventions. This study will promote improved implementations of
psychopharmacological and neurofeedback treatments, which are currently lacking. In conclusion, this study
furthers the Agency’s mission for children to achieve healthy and productive lives. It may serve as a platform for
future investigations of the complex interplay between maternal mental illness in the postpartum period, mother–
infant bonding, and the underlying neurobiological mechanisms.

## Key facts

- **NIH application ID:** 10130582
- **Project number:** 5R21HD100817-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Sharon Dekel
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $210,000
- **Award type:** 5
- **Project period:** 2020-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10130582

## Citation

> US National Institutes of Health, RePORTER application 10130582, Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development (5R21HD100817-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10130582. Licensed CC0.

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