Trajectories of maternal depressive symptoms during pregnancy and the first 12 months postpartum and child externalizing and internalizing behavior at three years

Abstract

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.

Testing the birth attitude profile scale in a Swedish sample of women with fear of birth

“…The variables that differed between the two clusters were all related to mental health problems, in that the women either had a history of mental illness, ongoing depressive symptoms or anxiety. Co-morbidity is common in women with fear of birth [33] and women might need treatment for their mental problems, as mental health problems could affect the health of both mother and baby [34], as well as prenatal attachment [35], for a long period after birth [34,36].…”

The pregnancy intention to have a second child and antenatal depressive symptoms in Chinese women under the new two-child-per-couple policy

“…2 Department of Obestetrics, the Third Xiangya Hospital of Central South University,Changsha, China. 3 Department of Gynecology, the Third Xiangya Hospital of Central South University, Changsha, China. 4 Department of Psychiatry, the Third Xiangya Hospital of Central South University, Changsha, China.…”

“…Antenatal depression which can occur in any time during pregnancy, has been considered as a major public health problem. The consequences of antenatal depression may be severe and far-reaching, negatively affecting the mother and infant [1,2], including the increased risk of perinatal complications, adverse perinatal outcomes [3], and adverse effects on the development of infant cognition, behavior, emotion and intellectual [4].Evidence has shown that 50% postpartum depression begins at antenatal period [5], and antenatal depression is the most effective predictive factor for postpartum depression [6]. However, due to some physiological symptoms of pregnancy are overlapped with the antenatal depressive symptoms, it is difficult to well recognize the antenatal depressive symptoms [7].…”

Child Health: Is It Really Assisted Reproductive Technology that We Need to Be Concerned About?

“…Perinatal depression (depression during pregnancy and postpartum period) particularly has a negative influence on infant and child development. 142,143 Various studies have shown that children born to women experiencing perinatal depression are at a higher risk for experiencing adverse behavioral and developmental outcomes including preterm birth, 144 externalizing and internalizing behaviors, 145,146 poor growth, 147 and reduced cognitive functioning. 148 Fathers are also at risk for experiencing perinatal depression, 149 though research on fathers' depression status during this time period is scarce 150,151 and its effect on child outcomes is unclear.…”