Ann. N.Y. Acad. Sci. 1032: 234–236 (2004). © 2004 New York Academy of Sciences.
Negative Affect in Offspring of Depressed
Mothers Is Predicted by Infant Cortisol Levels
at 6 Months and Maternal Depression during
Pregnancy, but Not Postpartum
R.L. HUOT,a P.A. BRENNAN,a Z.N. STOWE,b P.M. PLOTSKY,b AND
Departments of aPsychology and bPsychiatry and Behavioral Sciences,
Emory University, Atlanta, Georgia 30322, USA
ABSTRACT: This study tests the hypothesis that maternal depression during
pregnancy predicts temperament in offspring aged 6 m to 5 y. Previous studies
have shown that maternal depression is related to negative affect and that cer-
tain temperament factors, such as negative affect and behavioral inhibition, in
children predict affective disorders. Here, maternal depression is divided into
depression during pregnancy vs. depression postpartum. Maternal depression
was determined by the Beck Depression Inventory (BDI) throughout pregnan-
cy and postpartum (prospectively) and by a diagnostic interview (SCID) at 6
months postpartum. The data show that maternal depression during pregnan-
cy, but not postpartum, predicted the ratings of negative affect in the offspring.
Importantly, symptoms of depression in the mother (BDI) were used as a con-
trol variable in the analyses in order to control for potential bias related to the
mother’s mood. In addition, cortisol levels in response to a mild stressor at 6
months of age predicted negative affect in infants and toddlers. We conclude
that the effects of maternal depression on behavioral problems and vulnerabil-
ity to mental illness may be mediated by altered temperament and enhanced
KEYWORDS: negative affect; depression; cortisol levels; infants; pregnancy;
Maternal depression has been linked to both biological and psychological out-
comes in offspring, including increased rates of premature delivery, enhanced re-
sponsivity to stressors, and increased vulnerability to the development of behavioral
problems and mental disorders.1 Because certain temperaments have been linked to
both increased stress responses and increased vulnerability to mental illness, we
hypothesized that maternal depression would be related to offspring temperament.2
Address for correspondence: R.L. Huot, Department of Psychology, Emory University,
Atlanta, GA 30322, USA.
235HUOT et al.: DEPRESSION AND CORTISOL LEVELS
Previous research has shown that infants of depressed mothers show more “negative
affect” in their interactions with their mothers and strangers.3 However, these studies
have typically focused on the association between current (postpartum) maternal de-
pression and infant behavior. We hypothesized that maternal depression during preg-
nancy would be associated with negative affect in the offspring and that the infants’
cortisol response at 6 months of age would also predict negative affect.
MATERIAL AND METHODS
Mothers and their offspring (n = 123) were recruited from two previous studies.
About half (108) of the subjects previously participated in a prospective pregnancy
study that monitored depression throughout pregnancy and postpartum, including
the severity of maternal symptoms, as measured by the Beck Depression Inventory
(BDI), a continuous index of depression. Many (n = 71) of the subjects participated
in a laboratory infant assessment at 6 months postpartum, which included saliva col-
lection for cortisol measurement. About half (n = 57; 46%) of the subjects partici-
pated in both studies. The average age of the mothers at the birth of the infant was
33 years; 97% of the women were white and 96% were married; education level
ranged from graduating from a 2-year college to completing graduate or professional
school; 88% (109) were depressed; and 14 were community controls.
Temperament was assessed by maternal report using the Infant Behavioral Ques-
tionnaire (IBQ; 3–12 months, n = 54, 52% male), the Early Childhood Behavioral
Questionnaire (ECBQ; 18–36 months, n = 39, 64% male), or the Childhood Behav-
ioral Questionnaire (CBQ; 3–7 years, n = 31, 45% male), depending on the age of
the child. Factor analyses were conducted, and a negative affect factor was derived
for each age group. The negative affect factor included items measuring tempera-
ment traits such as distress, sadness, fear, shyness, and frustration. The level of de-
pression at the time the mother completed the survey was assessed using the BDI.
This was used as a control predictor variable in the regression analyses.
Cortisol levels were measured from infants in the laboratory at 6 months both at
baseline and after a mild series of stressors. Six samples were collected, the first at
study entry and another 15 minutes later. The infant was then exposed to a series of
mild stressors, including car seat restraint, 3 noise bursts, and arm restraint, and two
more samples were taken. We then conducted diagnostic and family history inter-
views and took two more samples. The first two samples are considered “baseline,”
the middle two samples are post-task, or “stress” samples, and the last two samples
are considered “recovery” samples.
RESULTS AND CONCLUSIONS
Hierarchical multiple regression analyses included age and sex of child and cur-
rent maternal BDI as control predictor variables. These analyses showed that the
average BDI during gestation predicted negative affect in offspring (R2 = 0.08, β =
0.31, P = 0.03). Since mothers’ mood at the time of the survey as measured using a
current BDI was included as a control predictor variable, this finding is not simply
a function of current maternal mood. Additional regression analyses showed that
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depression during the first two trimesters (R2 = 0.11, β = 0.35, P = 0.02), but not the
third (R2 = 0.03, NS) significantly predicted ratings of negative affect in the off-
spring (the first two trimesters were combined because too few data were available
for the first trimester). Postpartum depression was not associated with negative
affect (R2 = 0.03, NS).
As expected, multiple regression analysis controlling for child age and sex
revealed that total average cortisol at 6 months predicted negative affect in infants
and toddlers (R2 = 0.07, β = 0.28, P = 0.03). This relation seemed to be best
explained by the “stress” or “post-task” cortisol levels (R2 = 0.06, β = 0.26, P =
0.05), but not baseline (R2 = 0.03, NS) or recovery cortisol levels (R2 = 0.03, NS).
To summarize, maternal depression during pregnancy, particularly during the
first two trimesters, predicts negative affect in her offspring. In addition, infant cor-
tisol levels also predict negative affect. Based on these findings, we conclude that the
effects of maternal depression on behavioral problems and vulnerability to mental
illness may be mediated by altered temperament and enhanced stress responsive-
ness. It is also possible that the relation between maternal depression and offspring
temperament is mediated by an altered prenatal environment, such as elevated levels
of cortisol, or altered levels of other hormones, but these studies have not yet been
completed. Future studies will test this and alternate models.
1. FIELD, T. 1992. Infants of depressed mothers. Dev. Psychopathol. 4: 49–66.
2. MERIKANGAS, K.R., J.D. SWENDSEN, M.A. PREISIG, et al. 1998. Psychopathology and
temperament in parents and offspring: results of a family study. J. Affect. Disord. 51:
3. LUNDY, B.L., N.A. JONES, T. FIELD, et al. 1999. Prenatal depression effects on neo-
nates. Infant Behav. Devel. 22: 119–129.