Skip to main content

Advertisement

Log in

The emotional–behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Children exposed to maternal depression during pregnancy and in the postnatal period are at increased risk of a range of health, wellbeing and development problems. However, few studies have examined the course of maternal depressive symptoms in the perinatal period and beyond on children’s wellbeing. The present study aimed to explore the relationship between both the severity and chronicity of maternal depressive symptoms across the early childhood period and children’s emotional–behavioural difficulties at 4 years of age. Data from over 1,085 mothers and children participating in a large Australian prospective pregnancy cohort were used. Latent class analysis identified three distinct trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum: (1) no or few symptoms (61 %), (2) persistent subclinical symptoms (30 %), and (3) increasing and persistently high symptoms (9 %). Regression analyses revealed that children of mothers experiencing subclinical and increasing and persistently high symptoms were at least two times more likely to have emotional–behavioural difficulties than children of mothers reporting minimal symptoms, even after accounting for known risk factors for poor outcomes for children. These findings challenge policy makers and health professionals to consider how they can tailor care and support to mothers experiencing a broader spectrum of depressive symptoms across the early childhood period, to maximize opportunities to improve both short-and long-term maternal and child health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Schlotz W, Phillips D (2009) Fetal origins of mental health: evidence and mechansims. Brain Behav Immun 23(7):905–916

    Article  PubMed  Google Scholar 

  2. Downey G, Coyne J (1990) Children of depressed parents: an integrative review. Psychol Bull 108:50–76

    Article  CAS  PubMed  Google Scholar 

  3. Gelfand D, Teti D (1990) The effects of maternal depression on children. Clin Psychol Rev 10(3):329–353

    Article  Google Scholar 

  4. Kingston D, Tough S, Whitfield H (2012) Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry Hum Dev 43:683–714

    Article  PubMed  Google Scholar 

  5. Giallo R, Cooklin A, Nicholson J (2014) Risk factors associated with trajectories of mothers’ depressive symptoms across the early parenting period: an Australian-based longitudinal study. Arch Womens Ment Health 17:115–125

    Article  PubMed  Google Scholar 

  6. Woolhouse H, Gartland D, Mensah F, Brown S (2014) Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care. BJOG. doi:10.1111/1471-0528.12837

    PubMed  Google Scholar 

  7. Priest S, Austin M-P, Barnett B, Buist A (2008) A psychosocial risk assessment model (PRAM) for use with pregnant and postpartum women in primary care settings. Arch Womens Ment Health 11:307–317

    Article  CAS  PubMed  Google Scholar 

  8. Brown S, Lumley J (1998) Changing childbirth: lessons from an Australian survey of 1336 women. BJOG 105:143–155

    Article  CAS  Google Scholar 

  9. Gavin N, Gaynes B, Lohr K, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gyn 106:1071–1083

    Article  Google Scholar 

  10. O’Hara M, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8(1):37–54

    Article  Google Scholar 

  11. Horowitz J, Damato E, Solon L, von Metzsch G (1996) Identification of symptoms of postpartum depression: linking researh to practice. J Perinatol 16(5):360–365

    CAS  PubMed  Google Scholar 

  12. Affonso D, Lovett S, Paul S, Sheptak S, Nussbaum R, Newman L, Johnson B (1992) Dysphoric distress in childbearing women. J Perinatol 12(4):325–332

    CAS  PubMed  Google Scholar 

  13. Matthey S, Barnett B, Ungerer J, Waters B (2000) Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord 60:75–85

    Article  CAS  PubMed  Google Scholar 

  14. Beeghly M, Weinberg M, Olson K, Kernan H, Riley J, Tronick E (2002) Stability and change in level of maternal depressive symptomatology during the first postpartum year. J Affect Disord 71:169–180

    Article  PubMed  Google Scholar 

  15. McCue Horwitz S, Briggs-Gowan M, Storfer-Isser A, Carter A (2007) Prevalence, correlates, and persistence of maternal depression. J Womens Health 16(5):678–691

    Article  Google Scholar 

  16. McLennan J, Kotelchuck M, Cho H (2001) Prevalence, persistence, and correlates of depressive symptoms in a national sample of mothers of toddlers. J Am Acad Child Psychiatry 40(11):1316–1323

    Article  CAS  Google Scholar 

  17. Small R, Brown S, Lumley J, Astbury J (1994) Missing voices: what women say and do about depression after childbirth. J Reprod Infant Psychol 12(2):89–103

    Article  Google Scholar 

  18. Cents R, Diamantopoulou S, Hudziak J, Jaddoe V, Hofman F, Verhulst M, Lambregtse-van den Berg M, Tiemeier H (2013) Trajectories of maternal depressive symptoms predict child problem behaviour: the generation R study. Psychol Med 43:13–25

    Article  CAS  PubMed  Google Scholar 

  19. Muthen B (2002) Beyond SEM: general latent variable modeling. Behaviormetrika 29:81–117

    Article  Google Scholar 

  20. Nagin D, Tremblay R (2001) Analyzing developmental trajectories of distinct but related behaviours: a group-based method. Psychol Methods 6:18–34

    Article  CAS  PubMed  Google Scholar 

  21. Mora P, Bennett I, Elo I, Mathew L, Coyne J, Culhane J (2009) Distinct trajectories of perinatal depressive symptomatology: evidence from growth mixture modelling. Am J Epidemiol 169:24–32

    Article  PubMed Central  PubMed  Google Scholar 

  22. Kingston D, Tough S (2013) Prenatal and postnatal maternal mental health and school-age child development: a systematic review. Matern Child Health J (early view)

  23. Brennan P, Hammen C, Andersen M, Bor W, Najman J, Williams G (2000) Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5. Dev Psychol 36(6):759–766

    Article  CAS  PubMed  Google Scholar 

  24. Early Child Care Research Network (1999) Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. Dev Psychol 35:1297–1310

    Article  Google Scholar 

  25. Campbell S, Matestic P, von Stauffenberg C, Mohan R, Kirchner T (2007) Trajectories of maternal depressive symptoms, maternal sensitivity, and children’s functioning at school entry. Dev Psychol 43:1202–1215

    Article  PubMed  Google Scholar 

  26. Campbell S, Morgan-Lopez A, Cox M, McLoyd V (2009) A latent class analysis of maternal depressive symptoms over 12 years and offspring adjustment in adolescence. J Abnorm Psychol 118:479–493

    Article  PubMed Central  PubMed  Google Scholar 

  27. Grant K, Compas B, Sthulmacher A, Thurm A, McMahon S, Halpert J (2003) Stressors and child and adolescent psychopathology: moving form markers to mechanisms of risk. Psychol Bull 129:447–466

    Article  PubMed  Google Scholar 

  28. Gerard J, Krishnakumar A, Buehler C (2006) Marital conflict, parent-child relations, and youth maladjustment. J Fam Issues 27:951–975

    Article  Google Scholar 

  29. Wake M, Sanson A, Berthelsen D, Hardy P, Mission P, Smith K, Ungerer J, The LSAC Research Consortium (2008) How well are Australian infants and children aged 4–5 years doing? Findings from the Longitudinal Study of Australian Children Wave 1

  30. Sarkadi A, Kristiansson R, Oberklaid F, Bremberg S (2008) Fathers’ involvement and children’s developmental outcomes: a systematic review of longitudinal studies. Acta Paediatr 97:153–158

    Article  PubMed  Google Scholar 

  31. Brown S, Lumley J, McDonald E, Krastev A (2006) Maternal health study: a prospective cohort study of nulliparous women recruited in early pregnancy. BMC Pregnancy Childbirth 1:12

    Article  Google Scholar 

  32. Cox J, Holden J, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786

    Article  CAS  PubMed  Google Scholar 

  33. Murray D, Cox J (1990) Screening for depression during pregnancy with the Edinburgh depression scale (EDDS). J Reprod Infant Psychol 8(2):99–107

    Article  Google Scholar 

  34. Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586

    Article  CAS  PubMed  Google Scholar 

  35. Goodman R (2001) Psychometric properties of the strengths and difficulties (SDQ). J Am Acad Child Adolesc Psychiatry 40:1337–1345

    Article  CAS  PubMed  Google Scholar 

  36. Hawes D, Dadds M (2004) Australian data and psychometric properties of the Strengths and difficulties questionnaire. Aust NZ J Psychiatry 38:644–651

    Article  Google Scholar 

  37. Colley Gilbert B, Shulman H, Fischer L, Rogers M (1999) The pregnancy risk assessment monitoring system (PRAMS): methods and 1996 response rates from 11 states. Matern Child Health J 3:199–209

    Article  Google Scholar 

  38. Sanson A, Nicholson J, Ungerer J, Zubrick S, Wilson K, Ainley J, Berthelsen D, Bittman M, Broom D, Harrison L, Rodgers B, Sawyer M, Silburn S, Strazdins L (2002) Introducing the longitudinal study of Australian children. Australian Institute of Family Studies, Melbourne

    Google Scholar 

  39. Muthen L, Muthen B (1998–2013) Mplus User’s Guide. Muthen and Muthen, Los Angeles

  40. Belsky J, Pluess M (2009) Beyond diathesis stress: differential susceptibility to environmental influences. Psychol Bull 2009:885–908

    Article  Google Scholar 

  41. Boyce W, Ellis B (2005) Biological sensitivity to context: an evolutionary-developmental theory of the origins and functions of stress reactivity. Dev Psychopathol 17:271–301

    Article  PubMed  Google Scholar 

  42. Brennan P, Le Brocque R, Hammen C (2003) Maternal depression, parent-child relationships, and resilient outcomes in adolescence. J Am Acad Child Adolesc Psychiatry 42:1469–1477

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was approved by the following human research ethics committees: La Trobe University (2002/38); Royal Women’s Hospital, Melbourne (2002/23); Southern Health, Melbourne (2002-099B; Angliss Hospital, Melbourne (2002), Royal Children’s Hospital, Melbourne (27056A). This research was supported by project grants from the Australian National Health and Medical Research Council (numbers ID191222, ID433006 and ID1048829), a VicHealth Public Health Research Fellowship (2002-2006), a National Health and Medical Research Council Career Development Award (ID491205) and ARC Future Fellowship (IDFT110101036) awarded to S.J.B, and the Victorian Government’s Operational Infrastructure Support Program. We are extremely grateful to the women taking part in the study; to members of the Maternal Health Study Collaborative Group; and to members of the Maternal Health Study research team who have contributed to data collection and coding.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rebecca Giallo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Giallo, R., Woolhouse, H., Gartland, D. et al. The emotional–behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study. Eur Child Adolesc Psychiatry 24, 1233–1244 (2015). https://doi.org/10.1007/s00787-014-0672-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-014-0672-2

Keywords

Navigation