Association of maternal and paternal perinatal depression and anxiety with infant development: A longitudinal study

Perinatal Anxiety and Depressive Symptoms and Maternal Parenting Behavior During the First Three Years Postpartum: A Systematic Review

Background: Perinatal anxiety and depressive symptoms are prevalent and may influence parenting behaviors, yet their effects across distinct parenting dimensions remain unclear. Despite frequent co-occurrence, their combined impact is underexplored. Additionally, variability in how parenting behaviors are conceptualized hinders synthesis across studies. Categorizing parenting behaviors into protection, control, and guided learning provides a structured framework for understanding these associations. Objectives: This review aimed to assess (1) the differential associations between perinatal anxiety,depressive symptoms, and parenting behaviors across the protection, control, and guided learning dimensions, and (2) associations between comorbid anxiety-depressive symptoms and parenting behaviors. Methods: A systematic search was conducted across four databases in January 2024. Studies were included if they assessed perinatal anxiety and depressive symptoms and their associations with parenting behaviors during the first 3 years postpartum. Parenting behaviors were categorized into protection, control, and guided learning, and risk of bias was systematically evaluated. This review is registered with PROSPERO (CRD42023337333). Results: From 9673 screened documents, 20 studies met inclusion criteria. Associations were most frequent in the protection dimension, with higher perinatal anxiety and depressive symptoms linked to lower maternal sensitivity and responsiveness. In the control dimension, findings were mixed, with some studies linking maternal anxiety and depressive symptoms to greater controlling behaviors, while others found no significant associations. In the guided learning dimension, null findings predominated, though some studies identified links between higher anxiety, depressive symptom levels, increased intrusiveness, reduced cognitive stimulation, and disengagement. Few studies examined comorbid anxiety and depressive symptoms, but preliminary findings suggest associations with lower maternal sensitivity and reduced guided learning behaviors. Conclusions: Despite heterogeneity across studies, protection-related parenting behaviors were most consistently associated with perinatal anxiety and depressive symptoms. These findings highlight the need for targeted assessments and interventions to support affected mothers and their children.

Emotion regulation during pregnancy: A pathway from maternal childhood maltreatment to perinatal mental health

The perinatal period is a critical time during which the effects of maternal early life adversity can manifest for both the pregnant individual and their child. Early life adversity in the form of childhood maltreatment (CM) - encompassing abuse, neglect, and witnessing interpersonal violence - is widely prevalent. History of CM is linked to elevated perinatal mental health problems. Emotion regulation difficulties represent one potential mechanism through which CM can contribute to elevated risk for perinatal mental health. As such, this longitudinal study explored how CM influences maternal mental health outcomes through emotion dysregulation. A total of 128 participants from Nova Scotia, Canada, were recruited during pregnancy and completed study sessions during their third trimester and at 2 weeks postpartum. Participants reported experiences of CM and difficulties with emotion regulation during pregnancy, and symptoms of depression and anxiety at both timepoints. Mediation path analyses indicate that (1) greater CM was associated with increased difficulties in emotion regulation during pregnancy, (2) emotion dysregulation during pregnancy was linked to higher levels of anxiety and depression symptoms in pregnancy and the postpartum, and (3) emotion dysregulation mediated the association between CM and perinatal mental health outcomes. The findings highlight emotion dysregulation as one pathway through which early life adversity impacts maternal mental health across the perinatal period. Future research and clinical efforts should prioritize the development of accessible interventions aimed at supporting pregnant individuals with a history of CM, specifically in enhancing their emotion regulation abilities.

Longitudinal Influences on Maternal-Infant Bonding at 18 Months Postpartum: The Predictive Role of Perinatal and Postpartum Depression and Childbirth Trauma

Background: This study investigated the pathways through which various psychological problems occurring across the perinatal period influence mother-child bonding within the first 18 months postpartum, with a particular focus on the relationship between perinatal and postpartum depression and childbirth-related posttraumatic stress symptomatology. Methods: A multi-stage longitudinal design included three assessment points: recruitment and initial assessment in the third trimester of pregnancy (T1), a second assessment at 8 months postpartum (T2), and a final assessment at 18 months postpartum (T3). A total of N = 51 mothers completed all three waves (total follow-up period per participant: approximately 21 months). Sociodemographic data were collected, and all assessments were completed online. Results: Our findings revealed significant indirect effects, linking higher levels of perinatal depressive symptoms in the third trimester with mother-child bonding difficulties at 18 months postpartum. This association was mediated by both greater childbirth-related posttraumatic stress symptoms and elevated postpartum depressive symptoms at 8 months. Conclusions: These preliminary results highlight how complex perinatal factors at different stages (i.e., during pregnancy and early postpartum) influence mother-child bonding at 18 months postpartum. Understanding these pathways is essential in order to inform targeted interventions and to promote optimal maternal mental health and bonding outcomes.

Psychometric testing of Chinese version of screening tools (PASS) and GAD among perinatal population: hospital based evidence 2023

BACKGROUND

Anxiety disorders are increasing worldwide, untreated anxiety is linked to maternal and child health outcomes. The purpose of this study is to test psychometric properties of the Perinatal Anxiety Screening Scale (PASS) among Chinese women.

METHODS

The PASS was translated into Chinese following Beaton's intercultural debugging guide. A total of 494 women in the antenatal and postnatal phase participated ( 268 antenatal and 186 postnatal ) were recruited between March 2023 and July 2023 from two hospitals in Sichuan Province, China. The instruments included the demographic characteristics form, PASS, Edinburgh Postnatal Depression Scale (EPDS), and Generalized Anxiety Disorder-7 (GAD-7). The confirmatory factor analysis (CFA), internal consistency reliability and convergent validity were assessed.

RESULTS

The mean age of the participant was 31.67 years (SD = 3.78; range from 23 to 49). The CFA showed that four-factor model of the Chinese-PASS had an excellent fit to the data ( χ2 = 1481.2477; df = 425; χ2/df = 3.485; RMSEA = 0.071; CFI = 0.871; NNFI = 0.828; TLI = 0.859; and IFI = 0.871). The Cronbach's alpha coefficient of total scale was 0.950, and the split-half reliability of total scale was 0.907. The PASS significantly correlated with EPDS (r = 0.732) and GAD-7 (r = 0.763). The area under the ROC curve for PASS scores was 0.91 (SE = 0.01; 95% CI = 0.89-0.94). At cut-off score of ≥ 19.5, the sensitivity was 0.87. The area under the ROC curve for GAD-7 scores was 0.89 (SE = 0.02; 95% CI = 0.86-0.92). At cut-off score of ≥ 3.5, the sensitivity was 0.82.

CONCLUSIONS

The result of this study show that the Chinese-PASS had a reasonably adequate validity and reliability and can be used to screen for anxiety disorder among women during the perinatal period.

The impact of perceived caregiver anxiety and stress during childhood on late-life depression: evidence from the China Health and Retirement Longitudinal Study

Introduction

This study investigates the long-term impact of perceived caregiver anxiety and stress during childhood on late-life depression. Adverse childhood experiences related to caregiver mental health may significantly influence emotional well-being, and this study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) to explore these associations.

Methods

CHARLS data were analyzed for individuals who reported perceived caregiver anxiety and stress. Depression was measured using the CES-10 depression scale. Multivariate logistic regression models examined the relationship between caregiver anxiety and stress frequency and late-life depression, adjusting for confounders like socioeconomic status, health behaviors, and demographics.

Results

Childhood exposure to caregiver anxiety and stress significantly increased the risk of depression in later life (p < 0.05), with stronger effects observed among individuals with female caregivers. The risk escalated with the frequency of caregiver anxiety episodes. After adjusting for covariates, the association for male caregivers weakened, highlighting the potential role of other mediators.

Discussion

The results highlight the critical importance of parental mental health, especially maternal anxiety, in mitigating intergenerational mental health risks. Targeted interventions for caregiver mental health, particularly for female caregivers, are crucial. Longitudinal studies are needed to better establish causality and further investigate these mechanisms.

Peripartum Depression: What's New?

PURPOSE OF THE REVIEW

Peripartum depression (PPD), including both depression during pregnancy and postpartum, is the most frequent health disorder during the perinatal period. It is a significant public health issue in many countries due to its prevalence and its impact on women, as well as on their partners and offspring. Here, we will attempt to untangle the most recent studies and publications, considering what it is essential to know in 2024 about PPD as a specific perinatal issue.

RECENT FINDINGS

PPD appears to be a very heterogeneous disorder in which a complex interplay between different factors contributes to its pathophysiology. Thus, the need to enhance diagnosis and referral through a better understanding of its severity and co-morbidities has emerged as a major public health issue. Indeed, research has consistently shown that PPD negatively impacts parent-infant interactions and infants' cognitive, social, and emotional development. Evidence underlining its global risk has accumulated over the past three decades, but many questions remain, including how these vulnerable offspring developmental trajectories unfold.

Examining the Relation Between Prenatal Emotion Dysregulation and Toddler Vocabulary Development: A Biobehavioral Approach

Early language is shaped by parent-child interactions and has been examined in relation to maternal psychopathology and parenting stress. Minimal work has examined the relation between maternal emotion dysregulation and toddler vocabulary development. This longitudinal study examined associations between maternal emotion dysregulation prenatally, maternal everyday stress at 7 months postpartum, and toddler vocabulary at 18 months. Data were collected from 289 typically developing, monolingual children (54% female) and their mothers (63% White and non-Hispanic; 56% held a college degree). During pregnancy, maternal emotion dysregulation was measured via self-report and resting respiratory sinus arrhythmia (RSA). Mothers completed questionnaires about their perceived everyday stress and their child's vocabulary at 7 and 18 months postpartum, respectively. Path analysis revealed that expectant mothers' self-reported emotion dysregulation was indirectly associated with toddlers' expressive vocabulary via their level of postpartum perceived everyday stress. In addition, prenatal maternal resting RSA directly predicted toddlers' expressive vocabulary size. These findings yield insights into the mechanisms by which perinatal mental health may shape early language development and highlight the potential utility of interventions targeting emotion dysregulation during pregnancy.

Associations between maternal depression trajectories and infant neurodevelopment at eight months

BACKGROUND

Maternal depression is an increasingly recognized risk factor of child neurodevelopment difficulties. Few studies have investigated the association between the severity and duration of maternal depression and child development. We aimed to identify whether trajectories of maternal depressive symptoms from pregnancy to six months postpartum are associated with child development at eight months.

METHODS

We included 988 mother-child pairs who participated in Shenzhen Birth Cohort Study, which was conducted in Shenzhen Nanshan Maternity & Child Healthcare Hospital of China. Maternal depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at late pregnancy, 1, 3 and 6 months postpartum. Child emotional and behavioral development were assessed by Ages and Stages Questionnaires: Social-Emotional (ASQ-se) and Ages and Stages Questionnaires-Third Edition (ASQ-3) at aged 8 months. Latent profile analysis (LPA) was used to identify the trajectories of maternal depressive symptoms. Univariate and multivariate linear regression were conducted to explore the association between the depressive symptoms trajectories and child development.

RESULTS

Four trajectories of maternal depressive symptoms were identified by LPA: low (n = 597), subclinical (n = 91), moderately low and increasing (n = 246) and persistently high (54). Multivariable regression model showed that children of mothers with persistently high depressive symptoms were more likely to have lower scores in three ASQ-3 domains: fine motor (beta [95%C]): -2.30 [-4.32, -0.29], problem-solving (-3.72 [-5.81, -1.62]) and personal-social motor (-2.56 [-4.98, -0.15]), but higher ASQ-se scores (9.49 [5.09, 13.9]). Compared to children of mothers with low depressive symptoms, subclinical depressive symptoms were prediposed to having lower scores in two ASQ-3 domains: communication motor (-2.48 [-4.32, -0.64]) and gross motor (-2.35 [-4.2,-0.51]) and lower ASQ-se scores(4.86 [2.54, 7.18]).

CONCLUSION

Higher levels of maternal depression symptoms were associated with increased risk of child developmental delay, highlighting the importance of early intervention and addressing maternal depression from pregnancy through early childhood.

Maternal perinatal social support and infant social-emotional problems and competencies: a longitudinal cross-cohort replication study

PURPOSE

Maternal perinatal social support is theorised to promote offspring social-emotional development, yet few studies have prospectively examined this relationship. Findings may inform preventative intervention efforts, to support a healthy start to emotional life.

METHODS

This study examined whether maternal social support perinatally predicts infant social-emotional development at 12 months of age in two longitudinal cohort studies: The Australian Temperament Project (ATP) (n = 1,052 mother-infant dyads [653 mothers, M age_at_birth = 32.03, 88% Australian-born; 1,052 infants, 52% girls]) and The Triple B Pregnancy Cohort Study (Triple B) (n = 1,537 dyads [1,498 mothers, M age_at_birth = 32.53, 56% Australian-born; 1,537 infants, 49% girls]). Social support was assessed at pregnancy (third trimester) and eight-weeks post-birth. Infant social-emotional competencies (ATP: Brief Infant and Toddler Social and Emotional Assessment (BITSEA), Competencies Scale; Triple B: Bayley Scales of Infant and Toddler Development-Social Emotional Scale) and problems (ATP: BITSEA, Problems Scale; Triple B: Ages and Stages Questionnaires: Social-Emotional Scale), were assessed at 12-months of age.

RESULTS

In ATP, social support was associated with lower offspring problems (pregnancy: β = -0.15; post-birth: β = -0.12) and greater competencies (pregnancy: β = 0.12; post-birth: β = 0.16) at 12 months. In Triple B, social support also predicted lower offspring problems (pregnancy: β = -0.11; post-birth: β = -0.07) and greater competencies (pregnancy: β = 0.07) at 12 months. Findings did not indicate an association between support at eight-weeks post-birth and subsequent competencies (β = 0.06).

CONCLUSIONS

Evidence suggests that perinatal social support promotes healthy infant social and emotional development. These results underscore the critical importance of social support for mothers transitioning into parenthood.

Characteristics and outcomes of infants admitted to a parent-infant inpatient psychiatric unit: A pilot study

Inpatient parent-infant psychiatric units (PIUs) are considered "gold standard" for treating maternal mental illness, with well-documented positive outcomes for mothers. However, little research addresses outcomes for infants in these units, who often face significant developmental and socio-emotional adversity. This pilot study aimed to evaluate the characteristics and progress of an Australian PIU population, focusing on the impact of PIU admission on infant outcomes. Over 3 months, 31 consecutively admitted mother-infant pairs (dyads) were assessed through interviews, observations, and standardized measures to evaluate maternal and infant characteristics and progress from admission to discharge. Maternal well-being and the mother-infant relationship improved. Infants exhibited high levels of physical (29%) and developmental concerns (80.6%). 22.6% receiving an Axis I infant mental health diagnosis. Infant socio-emotional responsiveness improved significantly, as measured by the modified Alarm-Distress Baby Scale, indicating a positive impact of PIU admission. The small sample size and reliance on clinician-observed measures limit the generalizability of the findings. PIU infants are particularly vulnerable, and PIU admission may ameliorate socio-emotional responsiveness. Further research with larger samples and extended follow-up is needed to determine the most effective intervention strategies during and after PIU admission to maximize benefits for these infants.

Suicidal ideation in Chinese adolescents: prevalence, risk factors, and partial mediation by family support, a cross-sectional study

BACKGROUND

Suicidal ideation is a pressing public health concern, particularly among adolescents. The objective of this study was to examine the prevalence of and factors associated with suicidal ideation in Chinese adolescents, addressing an important gap in current research.

METHODS

This study employed an online survey of 3443 adolescents in Lianyungang, using a cross-sectional design. The assessment included the use of the Patient Health Questionnaire-9, the seven-item Generalized Anxiety Disorder instrument, and the Perceived Social Support Scale to evaluate suicidal ideation, anxiety symptoms, and social support in adolescents, respectively.

RESULTS

In adolescents, the prevalence of suicidal ideation was 22.1%, with a significantly higher proportion among female adolescents than among males (27.9% vs 16.9%, P < 0.001). Binary regression analysis identified (OR = 1.788, 95% CI: 1.467-2.177, P < 0.001), anxiety symptoms (OR = 10.035, 95% CI: 7.441-13.534, P < 0.001), total PHQ-9 scores of mothers (OR = 1.040, 95%CI: 1.003 - 1.078, P = 0.034), total GAD-7 scores of mothers (OR = 0.958, 95%CI: 0.919 - 0.998, P = 0.039), and moderate parental relationships (OR = 2.042, 95% CI: 1.630-2.557, P < 0.001) to be risk factors for suicidal ideation; family support was a protective factor (OR = 0.888, 95% CI: 0.859-0.918, P < 0.001). Furthermore, family support partially mediates the relationship between anxiety symptoms and suicidal ideation among adolescents (9.28%).

CONCLUSIONS

This study highlights high adolescent suicidal ideation rates and recommends gender-specific interventions, anxiety management, and family support for improvement in mental health status.

A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses

BACKGROUND

Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the mother, fetus, and newborn child. However, maternal-perinatal cost-utility analyses (CUAs) often only consider either maternal or child health outcomes. Challenges include, but are not limited to, measuring fetal, newborn, and infant health outcomes, and assessing their impact on maternal HRQoL. It is also important to recognize the impact of maternal-perinatal health on family members' HRQoL (i.e., family spillover effects) and to incorporate these effects in maternal-perinatal CUAs.

OBJECTIVE

The aim was to systematically review the methods used to include health outcomes of pregnant women, fetuses, and children and to incorporate family spillover effects in maternal-perinatal CUAs.

METHODS

A literature search was conducted in Medline, Embase, EconLit, Cochrane Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Network of Agencies for Health Technology Assessment (INAHTA), and the Pediatric Economic Database Evaluation (PEDE) databases from inception to 2020 to identify maternal-perinatal CUAs that included health outcomes for pregnant women, fetuses, and/or children. The search was updated to December 2022 using PEDE. Data describing how the health outcomes of mothers, fetuses, and children were measured, incorporated, and reported along with the data on family spillover effects were extracted.

RESULTS

Out of 174 maternal-perinatal CUAs identified, 62 considered the health outcomes of pregnant women, and children. Among the 54 quality-adjusted life year (QALY)-based CUAs, 12 included fetal health outcomes, the impact of fetal loss on mothers' HRQoL, and the impact of neonatal demise on mothers' HRQoL. Four studies considered fetal health outcomes and the effects of fetal loss on mothers' HRQoL. One study included fetal health outcomes and the impact of neonatal demise on maternal HRQoL. Furthermore, six studies considered the impact of neonatal demise on maternal HRQoL, while four included fetal health outcomes. One study included the impact of fetal loss on maternal HRQoL. The remaining 26 only included the health outcomes of pregnant women and children. Among the eight disability-adjusted life year (DALY)-based CUAs, two measured fetal health outcomes. Out of 174 studies, only one study included family spillover effects. The most common measurement approach was to measure the health outcomes of pregnant women and children separately. Various approaches were used to assess fetal losses in terms of QALYs or DALYs and their impact on HRQoL of mothers. The most common integration approach was to sum the QALYs or DALYs for pregnant women and children. Most studies reported combined QALYs and incremental QALYs, or DALYs and incremental DALYs, at the family level for pregnant women and children.

CONCLUSIONS

Approximately one-third of maternal-perinatal CUAs included the health outcomes of pregnant women, fetuses, and/or children. Future CUAs of maternal-perinatal interventions, conducted from a societal perspective, should aim to incorporate health outcomes for mothers, fetuses, and children when appropriate. The various approaches used within these CUAs highlight the need for standardized measurement and integration methods, potentially leading to rigorous and standardized inclusion practices, providing higher-quality evidence to better inform decision-makers about the costs and benefits of maternal-perinatal interventions. Health Technology Assessment agencies may consider providing guidance for interventions affecting future lives in future updates.

Maternal antenatal mental health and its associations with perinatal outcomes and the use of healthcare services in children from the NINFEA birth cohort study

To investigate the associations between maternal mental health disorders before and during pregnancy and perinatal outcomes and child healthcare utilization between 6 and 18 months of age. Among the 6814 mother-child pairs from the Italian Internet-based NINFEA birth cohort, maternal depression, anxiety, and sleep disorders diagnosed by a physician before and during pregnancy were assessed through self-reported questionnaires completed during pregnancy and 6 months after delivery. Perinatal outcomes (preterm birth, birth weight, small for gestational age, congenital anomalies, and neonatal intensive care unit (NICU)) and children's healthcare utilization (emergency department (ED) visits, hospitalizations, and outpatient visits) were reported by mothers at 6 and 18 months postpartum. We used regression models adjusted for maternal age, education, parity, country of birth, region of delivery, and household income. Maternal mental health disorders were not associated with perinatal outcomes, except for depression, which increased the risk of offspring admission to NICU, and anxiety disorders during pregnancy, which were associated with preterm birth and lower birth weight. Children born to mothers with depression/anxiety disorders before pregnancy, compared to children of mothers without these disorders, had an increased odds of a visit to ED for any reason (odds ratio (ORadj) = 1.26, 95% confidence interval (CI): 1.02-1.54), of an ED visit resulting in hospitalization (ORadj = 1.75, 95%CI: 1.27-2.42), and of planned hospital admissions (ORadj = 1.55, 95%CI: 1.01-2.40). These associations with healthcare utilization were similar for mental disorders also during pregnancy. The association pattern of maternal sleep disorders with perinatal outcomes and child healthcare utilization resembled that of maternal depression and/or anxiety disorders with these outcomes.   Conclusion: Antenatal maternal mental health is a potential risk factor for child-health outcomes and healthcare use. Early maternal mental health interventions may help to promote child health and reduce healthcare costs. What is Known: • Poor maternal mental health affects pregnancy outcomes and child health, and children of mothers with mental health conditions tend to have increased healtcare utilization. • Parents with poor mental health often face challenges in caring for their children and have less parenting self-efficacy, which could potentially lead to frequent medical consultations for minor health issues. What is New: • Maternal pre-pregnancy mental disorders were not associated with preterm birth, low birth weight, SGA, and congenital anomalies, except for depression, which increased the risk of offspring admission to NICU. Anxiety disorders during pregnancy were associated with lower birth weight and an increased odds of preterm birth. • Maternal depression and/or anxiety and sleep disorders, both before and during pregnancy, were associated with an increase in children's healthcare utilization between 6 and 18 months of life.

Neurobiological and Behavioral Underpinnings of Perinatal Mood and Anxiety Disorders (PMADs): A Selective Narrative Review

Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes.

Perinatal depression and infant and toddler neurodevelopment: A systematic review and meta-analysis

Many studies have focused on the effect of perinatal depression on neurodevelopment among children and adolescents. However, only a few studies have explored this relationship in infants and toddlers with inconsistent results. We performed a systematic review and meta-analysis to evaluate the association between perinatal depression and infant and toddler neurodevelopment during the first two postnatal years. Twenty-three studies were included in this meta-analysis. Perinatal depression was associated with poorer cognitive (Cohen's d = -0.19, SE= 0.06, 95% CI = -0.30 to -0.08), language (Cohen's d = -0.24, SE = 0.09, 95% CI = -0.40 to -0.07), and motor (Cohen's d = -0.15, SE = 0.05, 95% CI = -0.26 to -0.05) development. Subgroup analyses showed that the types of maternal depression (prenatal depression vs. postnatal depression), the method of measuring maternal depression (rating scale vs. diagnostic interview), and the time interval between assessment of exposure and outcome had an impact on the observed effect about neurodevelopment of infants and toddlers. In addition, the results of our study pointed to a stronger significant association between prenatal depression and cognitive, language, and motor delays in infants and toddlers, whereas the association between postnatal depression and cognitive, language, and motor delays in infants and toddlers was not statistically significant. In conclusion, this study provided convincing evidence that the perinatal window is a sensitive period for offspring neurodevelopment.

Associations between mothers' and fathers' depression and anxiety prior to birth and infant temperament trajectories over the first year of life: Evidence from diagnoses and symptom severity

BACKGROUND

Developmental shifts in infant temperament predict distal outcomes including emerging symptoms of psychopathology in childhood. Thus, it is critical to gain insight into factors that shape these developmental shifts. Although parental depression and anxiety represent strong predictors of infant temperament in cross-sectional research, few studies have examined how these factors influence temperament trajectories across infancy.

METHODS

We used latent growth curve modeling to examine whether mothers' and fathers' anxiety and depression, measured in two ways - as diagnostic status and symptom severity - serve as unique predictors of developmental shifts in infant temperament from 3 to 12 months. Participants included mothers (N = 234) and a subset of fathers (N = 142). Prior to or during pregnancy, both parents were assessed for lifetime diagnoses of depression and anxiety as well as current severity levels. Mothers rated their infants' temperament at 3, 6, and 12 months of age.

RESULTS

Mothers' depression and anxiety primarily predicted initial levels of temperament at 3 months. Controlling for mothers' symptoms, fathers' depression and anxiety largely related to temperament trajectories across infancy. Lifetime diagnoses and symptom severities were associated with distinct patterns.

LIMITATIONS

Infant temperament was assessed using a parent-report measure. Including an observational measure would provide a more comprehensive picture of the infants' functioning.

CONCLUSIONS

These results indicate that mothers' and fathers' mental health are uniquely associated with infant temperament development when measured using diagnostic status and/or symptom severity. Future studies should examine whether these temperament trajectories mediate intergenerational transmission of risk for depression and anxiety.