The chronicity and timing of prenatal and antenatal maternal depression and anxiety on child outcomes at age 5

Abstract

Background Maternal depression and anxiety have been associated with deleterious child outcomes. It is, however, unclear how the chronicity and timing of maternal mental health problems predict child development outcomes. The aim of the current study was to assess the effect of both chronicity and timing of maternal anxiety and depression in pregnancy, infancy, and the toddler period on children's internalizing and externalizing symptoms, as well as social and communication skills at age 5. Method Participants were 1,992 mother–child pairs drawn from a large prospective pregnancy cohort. Mothers reported on anxiety and depression symptoms with clinical screening tools at six time points between <25 weeks gestation and 3 years postpartum. Child outcomes were assessed at age 5. Results Effect sizes were small for brief incidents of depression/anxiety and increased for intermittent and chronic problems (i.e., three or more timepoints) compared with mothers who had never experienced clinical‐level anxiety or depression. Maternal anxiety/depression during pregnancy, infancy, and toddlerhood predicted all child outcomes, even after controlling for depression/anxiety during the other timepoints. However, maternal anxiety and depression during toddlerhood had a stronger association with child internalizing/externalizing symptoms and communication skills than either prenatal or postpartum depression/anxiety. Conclusions Increasing number of exposures to clinical‐level anxiety and depression is related to poorer child outcomes. Neither prenatal nor postpartum periods emerged as “sensitive” periods. Rather, maternal depression and anxiety during toddlerhood was more strongly associated with child outcomes at age 5. Results highlight the need for continued support for maternal mental health across early childhood.

Adverse childhood experiences and maternal anxiety and depression: a meta-analysis

“…However, for some women, postpartum depression may persist well beyond this timeframe and become chronic [ 50 ]. Our findings suggest that ACEs may put mothers at risk for depression across the perinatal period, which has been demonstrated to have particularly deleterious consequences for child and family outcomes [ 51 , 52 ]. More research is needed to better understand the course, continuity, and mechanisms of postpartum depression in women with ACEs, as well as interventions to offset its potential chronicity.…”

Peripartale psychische Belastung und Auswirkungen auf die frühe Elternschaft

“…Andererseits könnte sich die präpartale elterliche psychische Belastung postpartal anhaltend auf die Eltern-Kind-Beziehung und elterliche Kompetenzen auswirken (Glover 2014). So ergaben sich Hinweise auf eine Kontinuität psychischer Symptome von der Prä-in die Postpartalperiode, wobei eine wiederkehrende mütterliche Belastung im peripartalen Verlauf mit ungünstigeren emotionalen Folgen für das Kind einherging (Hentges et al 2020).…”

“…Dabei ergab sich kein signifikanter Zusammenhang zwischen schwangerschaftsspezifischen Ängsten und kindlicher Irritabilität im Mütterurteil, wohingegen postpartale Depressivität mit dem Erleben des Kindes korrelierte. Auch Hentges et al (2020) zeigten, dass die aktuelle mütterliche psychische Belastung im 5. Lebensjahr des Kindes trotz eines unabhängigen Zusammenhangs zwischen pränataler Angst/ Depression und dem kindlichen Outcome stärker mit der Einschätzung der kindlichen Symptomatik assoziiert war.…”

Transactional relations between maternal anxiety and toddler anxiety risk through toddler‐solicited comforting behavior

“…Beyond shared mother‐child genetic influences (Li et al, 2008; Mughal et al, 2018), mothers and toddlers may mutually influence each other's anxiety. Maternal anxiety in infancy/toddlerhood has predicted preschool/school‐aged children's internalizing problems (Gjerde et al, 2020; Hentges et al, 2020), and maternal anxiety has predicted increased child anxiety in middle childhood (Kerns et al, 2011; Poole et al, 2018). Child‐directed effects of broader temperament (e.g., effortful control, negative emotionality) on parents' psychological functioning and parenting have been found in the preschool/school years (Allmann et al, 2016; Klein et al, 2018; Oddi et al, 2013).…”