Deconstructing antenatal depression: What is it that matters for neonatal behavioral functioning?

Abstract

This prospective study examined the variability within clinical characteristics of antenatal maternal depression and cortisol levels for associations with newborn infant behavior using the Neonatal Behavioral Assessment Scale (NBAS; T.B. Brazelton, 1984). Participants were 81 pregnant women at risk for perinatal depression given their histories of depression prior to pregnancy. We took into consideration not only whether the woman experienced antenatal depression but also whether the depression met diagnostic criteria and variability in timing (onset and occurrence) of antenatal depression and symptom severity. Infants of mothers who became depressed during pregnancy scored less optimally on a subset of the NBAS scales, specifically those scales related to infant neuroregulation. Among the clinical characteristics of depression, the fetus' overall exposure to mothers' depression (reflected in the mean) was most often and most strongly associated with NBAS scales. In terms of timing, third-trimester exposure was significantly related to newborn behavior. The findings are discussed within the S.H. Goodman and I.H. Gotlib (1999) model for transmission of psychopathology to offspring of depressed mothers.

The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment

“…Future research should contrast the present results with those that examine the role of timing (i.e., onset, chronicity, and occurrence by trimester) and severity (i.e., dose) of prenatal depression and anxiety, and whether the depression and anxiety met diagnostic criteria relative to high symptom levels alone (e.g. [37] ).…”

“…Continuous scores were employed during the prenatal and postnatal assessments as research has shown that overall symptoms levels of maternal depression, in both developmental periods, can robustly affect child development. [37,38] In addition, recent meta-analyses suggest that (a) the size of the effect of maternal depression on child outcomes, as measured by maternal reports on scale formats versus clinical diagnoses, do not significantly differ; [5] and (b) increased reliability and validity in continuous versus categorical measures of psychopathology. [39] Hence, we believe, from a clinical perspective, that the current results, based on maternal self-reports on scale forms, can be considered informative with regard to the effects of maternal psychopathology on child maladjustment.…”

Perinatal depression influences on infant negative affectivity: Timing, severity, and co-morbid anxiety

“…Women with sub-clinical depression during pregnancy have been found to not differ significantly from women with diagnosed depression on stress, anxiety, and severity of depression symptoms (Goodman & Tully, 2009). In a study comparing neonatal behavioral functioning of infants, although infants of women with antenatal depression showed poorer neonatal neurobehavioral functioning than infants of women with no antenatal depression, infants of women with MDE did not differ from infants of women with sub-clinical depression (Goodman, Rouse, Long, Ji, & Brand, 2011). Consistent with this evidence, we hypothesized that infants of women with depression during pregnancy, whether defined by high depression symptoms alone or MDE diagnosis, would have significantly higher levels of NA than infants of women who did not experience clinically-significant depression during pregnancy.…”

The Prevalence of Depression in Pregnant Iranian Women: A Systematic Review and Meta-Analysis

“…Untreated depression may have short-term and long-term effects on the mother, including high-risk behaviors, preeclampsia, increased risk of postpartum depression, and pregnancy outcomes such as low birth weight, premature birth, small head circumference, increased distress after delivery, and disrupted sleep (6)(7)(8)(9). In addition, depression in pregnancy is related to a range of adverse pregnancy outcomes such as social isolation (10), marital discord (11), child's delay in motor and intellectual development (12), fetal growth restriction, and high-stress response in infants (13,14).…”