Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns

INTRODUCTION

Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health.

METHODS

In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health.

RESULTS

Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns.

DISCUSSION

Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.

Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support

Prenatal stress can have a lasting effect on women's mental health after childbirth. The negative effects may be particularly salient in women from low income and ethnic minority backgrounds, who are at increased risk for postpartum depression. However, social support may have the potential to attenuate the negative impact of stress. The present study evaluated 269 Mexican American women (ages 18-42; 83 % Spanish-speaking; median income $10,000-$15,000) for prenatal stress (daily hassles, family stress, partner stress, and culture-specific stress) in relation to depressive symptoms 6 weeks postpartum. Prenatal social support was examined as a buffer against the impact of prenatal stress. Partner stress, family stress, and daily hassles uniquely predicted depressive symptoms. Moderate and high levels of social support attenuated risk for depression due to family stressors. Prenatal interpersonal and daily stressors negatively impact the mental health of women after birth, but social support can mitigate some of these effects. Among Mexican American pregnant women, effective interpersonal support and stress management may be associated with reduced risk for postpartum depression.

Attention-deficit/hyperactivity disorder among children with and without intellectual disability: an examination across time

BACKGROUND

Children with intellectual and developmental disabilities are at heightened risk for mental disorders, and disruptive behaviour disorders appear to be the most prevalent. The current study is a longitudinal examination of attention-deficit/hyperactivity disorder (ADHD) among children with and without intellectual disability (ID) across ages 5 to 8.

METHOD

We assessed 228 5-year-old children, 87 with ID and 141 with typical development (TD), for clinical diagnoses using a structured interview. These interviews were conducted with mothers annually from child age 5 to 8.

RESULTS

Attention-deficit/hyperactivity disorder was over 3 times as prevalent in the ID group as in the TD group across ages 5, 6, 7 and 8. The diagnosis of ADHD tended to emerge earlier and was more stable in the ID group; however, the total number and relative frequency of ADHD symptoms endorsed appeared to be similar within the two groups across time. With respect to the developmental course, the trajectories of ADHD inattentive and hyperactive/impulsive symptoms over time were similar in the two groups.

DISCUSSION

Children with ID appear to be at heightened risk for ADHD and they may experience a longer and more persistent course of the disorder. These findings highlight the need for making interventions available for early treatment of this condition in children with ID.

Resilience and the course of daily parenting stress in families of young children with intellectual disabilities

BACKGROUND

Parenting stresses have consistently been found to be higher in parents of children with intellectual disabilities (ID); yet, some families are able to be resilient and thrive in the face of these challenges. Despite the considerable research on stress in families of ID, there is still little known about the stability and compensatory factors associated with everyday parenting stresses.

METHODS

Trajectories of daily parenting stress were studied for both mothers and fathers of children with ID across child ages 36-60 months, as were specific familial risk and resilience factors that affect these trajectories, including psychological well-being of each parent, marital adjustment and positive parent-child relationships.

RESULTS

Mothers' daily parenting stress significantly increased over time, while fathers' daily parenting stress remained more constant. Decreases in mothers' daily parenting stress trajectory were associated with both mother and father's well-being and perceived marital adjustment, as well as a positive father-child relationship. However, decreases in fathers' daily parenting stress trajectory were only affected by mother's well-being and both parents' perceived marital adjustment.

CONCLUSIONS

Parenting stress processes are not shared entirely across the preschool period in parents of children with ID. Although individual parent characteristics and high-quality dyadic relationships contribute to emerging resilience in parents of children with ID, parents also affect each others' more resilient adaptations in ways that have not been previously considered.

Thinking about feelings: emotion focus in the parenting of children with early developmental risk

BACKGROUND

Children with developmental delays exhibit more difficulty with certain emotional processes than their typically developing peers, which seems to partially account for the increased risk for the development of social problems in this population. Despite considerable study with typically developing populations, research on parental emotion socialisation in families of children with delays is scarce. This study examined the degree to which parents of children with early delays prioritized emotion relative to other important areas of child development and the degree to which they focused on emotion during relevant interactions with their children.

METHOD

Families of 8-year-old children with (n = 42) and without (n = 89) early developmental delays completed questionnaires and interviews, and participated in a parent-child emotion discourse task.

RESULTS

As predicted, parents of children with developmental delays reported lower prioritization of emotion and focused less on emotion during discourse than did parents of typically developing children. A model was supported in which a pathway existed from developmental status through prioritization to emotion focus. Emotion focus, in turn, predicted children's social skills as reported on by multiple informants.

CONCLUSIONS

Parents of children with early developmental delays may focus upon emotion less in their parenting than parents of typically developing children, and related behaviours show associations with children's social skill outcomes. Findings are discussed as an initial step in thinking about the role of emotion socialisation in the families of children with delays.

Minor parenting stresses with young children

The importance of major life stress and minor daily hassles associated with parenting was studied in 74 mothers and their 5-year-old children. Of interest were the relative and absolute contributions of the stress factors to indices of parental, child, and family functioning. Mothers completed questionnaires regarding stressors, aspects of parenting and individual psychological status, social support, family functioning, and child behavioral status. Mother-child pairs were also observed in interactions in a laboratory setting. Analyses indicated that life stress and parenting daily hassles significantly predicted aspects of child, parent, and family status. Hassles, however, proved to be a more powerful stress construct. Further analyses indicated that mothers' social support moderated the influence of hassles on indices of maternal behavior. The results are discussed in relation to the potential for minor parenting stresses to influence microsocial processes within parent-child relationships and contribute to dysfunction in children and families.

Longitudinal predictors of developmental status and social interaction in premature and full-term infants at age two

This investigation involved the longitudinal assessment of 30 mother-preterm and 40 mother-full-term dyads from birth to 2 years of age. Measures of maternal attitudes, maternal perception of the infant, and parental functioning were obtained at 1 and 8 months of infant age. Mother-infant interactions were observed at 4, 8, 12, and 24 months. Infant cognitive, motor, and language development was assessed at 4, 12, and 24 months. Results indicated that by age 2 years, no group differences were apparent on any child development, mother-child interaction, or maternal attitudinal measures; the lone exception was that preterms were significantly poorer in motor skills. This similarity in functioning at age 2 years was in marked contrast to earlier findings of major group differences at 12 months. Correlational and regression analyses indicated that the developmental and social interaction outcomes were predicted by different factors in the two groups; moreover, whereas 40%-60% of the variance in preterm infants' social and cognitive outcomes could be accounted for, only 15%-30% was accounted for in the full-term group. These results are discussed in terms of compensatory mechanisms that may characterize the parenting of high-risk infants, and of the applicability of transactional models of development.

Social interaction and developmental competence of preterm and full-term infants during the first year of life

37 mother-preterm and 42 mother-full-term infant pairs were assessed at 1, 4, 8, and 12 months following hospital discharge. The psychosocial functioning of the families was assessed at 1 and 8 months by interview, infants received developmental assessments at 4 and 12 months, and mother-infant interactions were observed in unstructured and semistructured situations at 4, 8, and 12 months. Significant differences were found in both mothers' and preterm infants' interactive behavior across the first year of life, extending the findings of previous research that had noted differences during early infancy. Additionally, preterms performed significantly below full-terms on measures of cognitive and language development corrected for gestational age. Results are discussed in terms of the persistence of interactive differences in mother-preterm pairs and the possible effects on their relationship and infant developmental outcome.

Adaptation of families with mentally retarded children: a model of stress, coping, and family ecology

Research concerned with families of mentally retarded children has often yielded inconsistent, and at times, contradictory findings. This inconsistency is partly due to methodological inadequacies and a narrow focus on unidimensional variables with unimodal measurements. In addition, no succinct model has been presented to explain family adaptation and the range of possible outcomes. In this paper a critical review focused on parents, siblings, parent-child interactions, and family systems was presented. A comprehensive conceptual model was proposed that accounts for (a) the range of possible familial adaptations, both positive and negative, involving the impact of perceived stress associated with the presence of a retarded child; and (b) the family's coping resources and ecological environments as interactive systems that serve to mediate the family's response to stress.

Effects of stress and social support on mothers and premature and full-term infants

This study examined the relationships of stress and social support to maternal attitudes and early mother-infant interactive behavior. 52 mother-premature infant pairs and 53 mother-full-term infant pairs were seen for structured home interviews at 1 month, and behavioral interactions at 4 months. Maternal life stress, social support, life satisfaction, and satisfaction with parenting were assessed at the 1-month home visit. Although no group differences were found, both stress and support significantly predicted maternal attitudes at 1 month and interactive behavior at 4 months when data were pooled. Mothers with greater stress were less positive in their attitudes and behavior, while mothers with greater support were significantly more positive. Intimate support proved to have the most general positive effects. Additionally, social support moderated the adverse effects of stress on mother's life satisfaction and on several behavioral variables. Maternal social support was further found to have several significant effects on infant interactive behavior. Results are discussed in terms of the ecological significance of social support to parenting and infants' early development.

Preventing mental retardation associated with gross obesity in the Prader-Willi syndrome

Twenty-seven patients with Prader-Willi syndrome have been described, ten of whom did not receive comprehensive management, nine who were diagnosed and treated after becoming obese, and eight who were diagnosed in infancy and responded to early preventative treatment. Intelligence scores declined in the first two groups, but the group receiving early treatment maintained a mean IQ score 20 points higher than the other two. Even though the underlying mechanism of this disorder remains undefined, a comprehensive early intervention program appears to improve prognosis.