Our results contrast with what is, to our knowledge, the only previous systematic review that examined the question of untreated depression because we found significant risks of 2 key perinatal outcomes, preterm birth and low birth weight. These are important results for pregnant women and clinicians to take into account in the decision-making process around depression treatment.

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Raising a child with an Autism Spectrum Disorder (ASD) presents significant challenges for parents that potentially have a impact on their health and wellbeing. The current study examined the extent to which parents experience fatigue and its relationship to other aspects of wellbeing and parenting. Fifty mothers of children with an ASD aged 2-5 years participated in the study. Compared with mothers of typically developing children, mothers of children with an ASD reported significantly higher fatigue, with overall scores in the moderate range. Factors associated with high levels of fatigue were poor maternal sleep quality, a high need for social support and poor quality of physical activity. Fatigue was also significantly related to other aspects of wellbeing, including stress, anxiety and depression, and lower parenting efficacy and satisfaction. The need for interventions to specifically target parental fatigue and its impact on families affected by ASDs both in the short and long term is clearly indicated.

BackgroundMost evidence of the association between maternal depression and children’s development is limited by being cross-sectional. To date, few studies have modelled trajectories of maternal depressive symptoms from pregnancy through the early postpartum years and examined their association with social emotional and behavior functioning in preschool children. The objectives of this study were to: 1) identify distinct groups of women defined by their trajectories of depressive symptoms across four time points from mid-pregnancy to one year postpartum; and 2) examine the associations between these trajectories and child internalizing and externalizing behaviors.MethodsWe analyzed data from the All Our Families (AOF) study, a large, population based pregnancy cohort of mother-child dyads in Alberta, Canada. The AOF study is an ongoing pregnancy cohort study designed to investigate relationships between the prenatal and early life period and outcomes for children and mothers. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Children’s behavioral functioning at age 3 was assessed using the Behavior Scales developed for the Canadian National Longitudinal Survey of Children and Youth. Longitudinal latent class analysis was conducted to identify trajectories of women’s depressive symptoms across four time points from pregnancy to 1 year postpartum. We used multivariable logistic regression to assess the relationship between trajectories of maternal depressive symptoms and children’s behavior, while adjusting for other significant maternal, child and psychosocial factors.Results1983 participants met eligibility criteria. We identified four distinct trajectories of maternal depressive symptoms: low level (64.7%); early postpartum (10.9%); subclinical (18.8%); and persistent high (5.6%). In multivariable models, the proportion of children with elevated behavior symptoms was highest for children whose mothers had persistent high depressive symptoms, followed by mothers with moderate symptoms (early postpartum and subclinical trajectories) and lowest for minimal symptoms. After accounting for demographic, child and psychosocial factors, the relationships between depression trajectories and child hyperactivity/inattention, physical aggression (subclinical trajectory only) and separation anxiety symptoms remained significant.ConclusionThese findings suggest both externalizing and internalizing children’s behaviors are associated with prolonged maternal depressive symptoms. There is a good case for the need to move beyond overly simplistic clinical cutoff approaches of depressed/not depressed in screening for perinatal depression. Women with elevated depressive symptoms at clinical and subclinical levels need to be identified, provided with evidence-based treatment, and monitored with repeat screening to improve maternal mental health outcomes and reduce the risk of associated negative outcomes on children’s early social-emotional and behavior development.

ObjectivesChildren exposed to social adversity—hardship as a result of social circumstances such as poverty or intergenerational trauma—are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes.DesignSystematic search conducted in CINAHL, MEDLINE and PsychInfo from January 2004 to October 2018 using the keywords ‘resilien* and child* in the title or abstract. Eligible studies: (1) described children aged 5–12 years; (2) identified exposure to social adversity; (3) identified resilience; and (4) investigated factors associated with resilience.Outcome measures(1) approaches to identifying resilience and (2) factors associated with resilient outcomes.ResultsFrom 1979 studies retrieved, 30 studies met the inclusion criteria. Most studies were moderate to high quality, with low cultural competency. Social adversity exposures included poverty, parent loss, maltreatment and war. Only two studies used a measure of child resilience; neither was psychometrically validated. Remaining studies classified children as resilient if they showed positive outcomes (eg, mental health or academic achievement) despite adversity. A range of child, family, school and community factors were associated with resilient outcomes, with individual factors most commonly investigated. The best available evidence was for cognitive skills, emotion regulation, relationships with caregivers and academic engagement.ConclusionsWhile there is huge variation in the type and severity of adversity that children experience, there is some evidence that specific individual, relational and school factors are associated with resilient outcomes across a range of contexts. Such factors provide an important starting point for effective public health interventions to promote resilience and to prevent or ameliorate the immediate and long-term impacts of social adversity on children.

Fatigue is common, and results suggest that fatigue contributes to adverse parental practices and experiences. However, possible risk factors for higher fatigue were identified in this study, indicating opportunities for intervention, management and support for parents.

The results revealed that the family level of risk and resilience factors were better predictors of sibling adjustment than siblings' own experiences of stress and coping resources, highlighting the importance of familial and parental contributions to the sibling adjustment process. The implications of these results for the design of interventions and supports for siblings are discussed.

BackgroundEmployment participation of mothers of young children has steadily increased in developed nations. Combining work and family roles can create conflicts with family life, but can also bring enrichment. Work–family conflict and enrichment experienced by mothers may also impact children's home environments via parenting behaviour and the couple relationship, particularly in the early years of parenting when the care demands for young children is high.MethodsIn order to examine these associations, while adjusting for a wide range of known covariates of parenting and relationship quality, regression models using survey data from 2151 working mothers of 4- to 5-year-old children are reported.Results/ConclusionResults provided partial support for the predicted independent relationships between work–family conflict, enrichment and indicators of the quality of parenting and the couple relationship.