Interactive Effects of Infant Gestational Age and Infant Fussiness on the Risk of Maternal Depressive Symptoms in a Nationally Representative Sample
Section snippets
Study Design and Sample
Data were drawn from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), a nationally representative, population-based longitudinal study of children born in the United States in 2001. Data were collected from >10,000 children and their parents at 9 months, with subsequent assessments at 24 months, preschool, and kindergarten timepoints. Data collection consisted of home visits with parent interviews and direct child assessments and included information on children's development
Covariates
Maternal and infant characteristics associated with prematurity or maternal depression were chosen a priori as covariates after a review of the literature. The following maternal characteristics were ascertained from the restricted ECLS-B birth certificate data: maternal age, race/ethnicity, marital status (married/ unmarried), history of prenatal smoking, history of breastfeeding (any breastfeeding, no breast feeding), and plurality (singleton, twin or multiple gestation). Also included were
Statistical Analysis
Maternal and child characteristics were examined using descriptive statistics. Multivariate, multinomial logistic regression using the SURVEYLOGISTIC procedure in SAS was used to examine the association between gestational age categories and infant fussiness with the outcome of maternal depressive categories. We controlled for variables that were related to gestational age and maternal depressive categories to adjust for potential confounding. We also examined whether the association between
Sample Characteristics
Our final sample of 8200 infants born between 24 and 41 weeks included 800 VPT (<32 weeks), 1500 MPLT (32–36 weeks), and 5900 term infants (37–41 weeks). Gestational age groups differed by select maternal (Table 1) and infant characteristics (Table 2). Compared with infants born FT, infants born VPT and MLPT were more likely to have mothers who were unmarried, have less than a high school education, have income <185% below the poverty line, and were less likely to have breastfed. They were also
Discussion
This is the first study to examine the interactive effects of the degree of prematurity (VPT, MLPT, FT) and infant fussiness (fussy vs not fussy) on the severity of maternal depressive symptoms in a nationally representative sample. Our study is also unique in its focus on predictors associated with both mild (ie, subclinical) depressive symptoms, as well as more commonly studied moderate-to-severe depressive symptoms. Although there is a paucity of research regarding child outcomes associated
Conclusions
Mothers of VPT with infant fussiness experienced increased odds of mild depressive symptoms whereas mothers of “fussy” MLPT and FT infants had increased odds of moderate-severe depressive symptoms, suggesting a potential need for closer surveillance and supports for these mothers. Pediatric providers can query mothers about their experiences of infant fussiness, which can help identify which mothers would benefit from additional depression screening, and referrals for additional services (eg,
Acknowledgments
Financial disclosure: Supported by the University of Michigan, NICHD (K08HD078506), The funding sources had no involvement in the study design, collection, analysis, interpretation of data, in the writing of the report, or in the decision to submit the article for publication
References (42)
- et al.
Patterns of psychological distress in mothers of preterm infants
Infant Behav Dev
(2015) - et al.
Very low birth-weight as a risk factor for postpartum depression four to six weeks postbirth in mothers and fathers: cross-sectional results from a controlled multicentre cohort study
J Affect Disord
(2015) - et al.
Parent–child interaction, maternal depressive symptoms and preterm infant cognitive function
Infant Behav Dev
(2012) - et al.
Epidemiology of late and moderate preterm birth
Semin Fetal Neonatal Med
(2012) - et al.
Gestational age and kindergarten school readiness in a national sample of preterm infants
J Pediatr
(2016) - et al.
Increased rate of parental postpartum depression and traumatization in moderate and late preterm infants is independent of the infant's motor repertoire
Early Human Dev
(2014) - et al.
Late-preterm birth, maternal symptomatology, and infant negativity
Infant Behav Dev
(2010) - et al.
The prognosis of minor depression in the general population: a systematic review
Gen Hosp Psychiatry
(2004) - et al.
Maternal depression and infant temperament characteristics
Infant Behav Dev
(2008) - et al.
Parental perceptions and infant temperament development
Infant Behav Dev
(2003)
Stress and health-related well-being among mothers with a low birth weight infant: the role of sleep
Social Sci Med
Supporting families as they transition home
Newborn Infant Nursing Rev
The paradox of prematurity: the behavioral vulnerability of late preterm infants and the cognitive susceptibility of very preterm infants at 36 months post-term
Infant Behav Devel
Does psychiatric history bias mothers' reports? An application of a new analytic approach
J Am Acad Child Adolesc Psychiatry
Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge
J Perinatol
Postnatal depressive symptoms among mothers and fathers of infants born preterm: prevalence and impacts on children's early cognitive function
J Dev Behav Pediatr
The effect of maternal depression and marital adjustment on young children's internalizing and externalizing behaviour problems
Child Care Health Dev
Long‐term cognitive outcomes of infants born moderately and late preterm
Dev Med Child Neurol
A comparison between late preterm and term infants on breastfeeding and maternal mental health
Matern Child Health J
Postpartum psychosocial distress and late preterm delivery
J Reprod Infant Psychol
Cited by (0)
The authors have no conflicts of interest to disclose.