Abstract
Background Maternal depression has been studied as a risk factor for child development and found to be associated with less secure attachment, worse cognitive and behavioural outcomes in childhood, and a possible increased risk of autism spectrum disorder (ASD). Despite the wealth of research investigating postnatal parental depression, most studies have small sample sizes, assess parental mood during later infancy, use a dichotomous measure of parental depression, or examine distant child behavioural and emotional outcomes, with limited focus on ASD.
Objectives This study examined the association between early maternal postnatal depressive symptoms and offspring’s mental health in a large cohort of term and preterm toddlers.
Methods Participants were 509 children enrolled in the Developing Human Connectome Project; 412 (80.9%) were born at term, and 97 (19.1%) were born preterm (<37 weeks gestation). Maternal postnatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at term. Children were followed-up at a median corrected age of 18.4 months (range 17.3 – 24.3) for neurodevelopmental assessment. Primary outcome measures were toddlers’ Child Behaviour Checklist 11/2-5 Total (CBCL) and Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores. Secondary outcome measures were the CBCL internalising and externalising sub-scores. Cognition was assessed with the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III). Multiple imputation (n=40) was carried out to account for missing data. Data were analysed with multiple linear regression, including clinical and socio-demographic confounders.
Results Higher maternal EPDS scores were associated with toddlers’ higher CBCL total scores (B=0.93, 95% CI 0.43–1.44, p<0.001, f2=0.05) and higher Q-CHAT scores (B=0.27, 95% CI 0.03–0.52, p<0.05, f2=0.01). Higher maternal EPDS score was associated with both internalising (B=0.22, 95% CI 0.08–0.36, p<0.01, f2=0.03) and externalising symptoms (B=0.40, 95% CI 0.20–0.61, p<0.001, f2=0.05), but not with cognitive outcomes in toddlers (B=-0.21, 95% CI -0.49–0.06, p>0.05). Maternal EPDS, and toddlers’ CBCL and Q-CHAT scores did not differ between preterm and term participants.
Conclusions Our findings indicate that children whose mothers had increased depressive symptoms in the early postnatal period exhibit more maternally-reported behavioural, emotional and neurodevelopmental problems in toddlerhood. Further research is needed to confirm the clinical significance of these findings.
