Maternal depression continues to play a role in children's development beyond infancy. The mediating effects of OT and synchronous, mutually regulated interactions underscore the role of plasticity in resilience. Results emphasize the need to follow children of depressed mothers across middle childhood and construct interventions that bolster age-appropriate synchrony.

Our findings, the first to test stress and immune biomarkers in depressed mothers and their children in relation to social behavior, describe mechanisms of endocrine synchrony in shaping children's stress response and immunity, advocate the need to follow the long-term effects of maternal depression on children's health throughout life, and highlight maternal depression as an important public health concern.

The long-term negative effects of maternal depression on child outcome are thought to be mediated in part by deficits in caregiving; yet, few studies utilized longitudinal cohorts and repeated observations to specify these links. We tested the impact of deficits in maternal regulatory caregiving across the first decade of life on children’s emotional, social, and cognitive outcomes at 10 years. A community birth cohort was repeatedly assessed for maternal depression across the first year and again at 6 and 10 years. At 9 months, 6 years, and 10 years patterns of regulatory caregiving were assessed during mother-child interactions; at 6 and 10 years children underwent psychiatric diagnosis; and at 10 years children’s emotion recognition (ERc), executive functions (EF), and social collaboration (SC) were evaluated. Depressed mothers displayed deficits to regulatory caregiving across development and their children exhibited more psychiatric disorders, lower SC, and impaired ERc. Structural equation modeling demonstrated both direct paths from dysregulated caregiving at 6 and 10 years to impaired child EF and ERc and mediated paths via child psychiatric disorder on all 3 outcomes. Effects of 9-month caregiving were only indirect, via child disorder, differentiating infants on risk versus resilient trajectories. Patterns of maternal caregiving were individually stable over time. Our findings demonstrate disruptions to core regulation-based abilities in children of depressed mothers beyond infancy, contribute to discussion on risk and resilience in the context of a distinct early life stress condition, and underscore late childhood as a period of specific vulnerabilities that should become a focus of targeted interventions.