Predictors of infant foster care in cases of maternal psychiatric disorders

Our aim was to investigate the factors associated with mother–child separation at discharge, after joint hospitalization in
psychiatric mother–baby units (MBUs) in France and Belgium. Because parents with postpartum psychiatric disorders are at risk
of disturbed parent–infant interactions, their infants have an increased risk of an unstable early foundation. They may be
particularly vulnerable to environmental stress and have a higher risk of developing some psychiatric disorders in adulthood.

This prospective longitudinal study of 1,018 women with postpartum psychiatric disorders, jointly admitted with their infant
to 16 French and Belgian psychiatric mother–baby units (MBUs), used multifactorial logistic regression models to assess the
risk factors for mother–child separation at discharge from MBUs. Those factors include some infant characteristics associated
with personal vulnerability, parents’ pathology and psychosocial context.

Most children were discharged with their mothers, but 151 (15 %) were separated from their mothers at discharge. Risk factors
independently associated with separation were: (1) neonatal or infant medical problems or complications; (2) maternal psychiatric
disorder; (3) paternal psychiatric disorder; (4) maternal lack of good relationship with others; (5) mother receipt of disability
benefits; (6) low social class.

This study highlights the existence of factors other than maternal pathology that lead to decisions to separate mother and
child for the child’s protection in a population of mentally ill mothers jointly hospitalized with the baby in the postpartum
period.