The impact of maternal depression in pregnancy on early child development

Centre for Child and Adolescent Health, University of the West of England, Bristol, UK.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.45). 07/2008; 115(8):1043-51. DOI: 10.1111/j.1471-0528.2008.01752.x
Source: PubMed


Postpartum depression in mothers is associated with developmental problems in their children. Many women who are depressed following childbirth are also depressed during pregnancy. The aim of this study was to examine the associations between maternal depressive symptoms during pregnancy and child development at 18 months of age.
A prospective cohort study, Avon Longitudinal Study of Parents and Children.
The former county of Avon, southwest England.
All pregnant women in the defined area with delivery dates between April 1991 and December 1992, 9244 women and their children.
Data were collected antenatally, at 18 and 32 weeks of gestation and at 8 weeks and 8 months postnatally, through postal questionnaires, including a self-report measure of depression (Edinburgh Postnatal Depression Scale [EPDS]). By the time their child was 18 months old, women completed five further questionnaires about their children's health and development.
Child development at 18 months using a modified Denver Developmental Screening Test (modified DDST).
Applying the standard 12/13 cutoff, 1565 (14%) women were depressed antenatally but not at either time-points postnatally. Employing the modified DDST, 893 (9%) children were developmentally delayed at 18 months of age. Persistent depression (EPDS > or = 10 at both time-points) is associated with developmental delay (adjusted OR 1.34, 95% CI 1.11-1.62). Applying the 12/13 and 14/15 cutoffs gave similar results. After further adjustment for postnatal depression, the effect sizes were slightly attenuated.
These findings highlight the importance of depression in pregnancy. Some effects on child development attributed to postpartum depression are caused in part by depressive symptoms during pregnancy.

Download full-text


Available from: Toity Deave
  • Source
    • "Maternal depression during pregnancy or the postpartum period has been associated with impaired mother–infant attachment and developmental difficulties in offspring.40 Children exposed to untreated antenatal depression are at higher risk for developmental delay, impaired language development, and lower intelligence quotient (IQ) scores,41–43 and poor socioemotional development, including worse emotional regulation and higher rates of depressive and anxiety symptoms.44–46 Others have shown that approximately a third of school-age children experience depressive, anxiety, or disruptive disorders while their mother is depressed.47 "
    [Show abstract] [Hide abstract]
    ABSTRACT: In pregnant women with major depression, the overarching goal of treatment is to achieve or maintain maternal euthymia, thus limiting both maternal and fetal exposure to the harmful effects of untreated or incompletely treated depression. However, the absence of uniformly effective therapies with guaranteed obstetric and fetal safety makes the treatment of major depression during pregnancy among the most formidable of clinical challenges. Clinicians and patients are still faced with conflicting data and expert opinion regarding the reproductive safety of antidepressants in pregnancy, as well as large gaps in our understanding of the effectiveness of most antidepressants and nonpharmacological alternatives for treating antenatal depression. In this paper, we provide a clinically focused review of the available information on potential maternal and fetal risks of untreated maternal depression during pregnancy, the effectiveness of interventions for maternal depression during pregnancy, and potential obstetric, fetal, and neonatal risks associated with antenatal antidepressant use.
    Full-text · Article · Sep 2014 · Drug, Healthcare and Patient Safety
  • Source
    • "The issue of whether prenatal SSRI use or the indication for SSRI use is the risk factor remains unresolved. Associations between maternal depression, the chief indicating condition for SSRI use, and developmental psychopathology in children have been reported (Brennan et al. 2000; Caplan et al. 1989; Carter et al. 2001; Deave et al. 2008; Huot et al. 2004). Diagnoses for psychiatric disorders before the birth of the child are more common among parents of children with ASD than parents of children without a diagnosis of ASD, and maternal depression appears to be a greater risk factor than paternal depression (Bolton et al. 1998; Daniels et al. 2008; Rai et al. 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD diagnosis, and health and socioeconomic status. There were 1.5 % of cases and 0.7 % of controls exposed to SSRIs during the pregnancy period, and higher effect estimates observed with longer use. We found evidence that in utero exposure to SSRIs increases a child's risk associated with ASD. These results, while adding to the limited knowledge on prenatal pharmacological exposures as potential ASD risk factors, need to be balanced against the benefits of indicated medication use by pregnant mothers.
    Full-text · Article · May 2014 · Journal of Autism and Developmental Disorders
  • Source
    • "[48], but they did not state what potential confounding factors were controlled for. Deave et al [49] reported findings from the UK Avon Longitudinal Study of Parents and Children in 9244 women and their children which showed an association between having EPDS ≥10 (usual cut-off score in high-income Anglophone countries to detect clinically significant symptoms in community samples) during pregnancy and risk of developmental delay in their infants at 18 months of age (OR 1.34, 95% CI 1.11–1.62). However, they used the Denver Developmental Screening Test to evaluate child development, which does not permit different developmental domains to be assessed. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA) and common mental disorders (CMD) on cognitive development of 6 months old infants in a developing country. A prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12-20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb <11 g/dL and serum ferritin <15 ng/mL. CMD symptoms were assessed by the Edinburgh Postnatal Depression Scale-Vietnam validation. Infant cognitive development was assessed by Bayley Scales of Infant and Toddler Development, 3(rd) Ed. Path analyses were performed to determine the direct and indirect, partly or fully mediated, causal effects of the antenatal exposures. A total of 497 pregnant women were recruited, of those 378 women provided complete data which were included in the analyses. Statistically significant direct adverse effects of persistent antenatal IDA (estimated difference of -11.62 points; 95% CI -23.01 to -0.22) and antenatal CMD (-4.80 points; 95% CI: -9.40 to -0.20) on infant Bayley cognitive scores at six months were found. Higher birthweight, household wealth, and self-rated sufficient supply of breastmilk were associated with higher cognitive scores. Maternal age >30 years and primiparity had an indirect adverse effect on infants' Bayley cognitive scores. These findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries.
    Full-text · Article · Sep 2013 · PLoS ONE
Show more