A group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally. The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy. Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.
Ninety four women and their first born children took part in a longitudinal study of maternal mental health during pregnancy and after delivery. The children's cognitive functioning was assessed at age 4 using the McCarthy scales, without knowledge of the mothers' psychiatric history or current health. As expected girls performed slightly better than boys and children from middle class and professional families did better than children from working class homes, as did children whose mothers had achieved at least one A level at school. Significant intellectual deficits were found in the children whose mothers had suffered with depression, but only when this depression occurred in the first year of the child's life. Marital conflict and a history of paternal psychiatric problems were independently linked with lower cognitive test scores; together with a working class home background these were the only factors that contributed to the deleterious effect of maternal postnatal depression.
Ninety-two women and their first-born children took part in a longitudinal survey of maternal mental health. When the children were four years old, their mothers were interviewed by means of the Behavioural Screening Questionnaire, and the children's problems were rated by a psychiatrist, who was unaware of the mothers' psychiatric histories or of assessments of their current health. As expected, mothers who were concurrently depressed reported significantly more behavioural difficulties in their children. Marital disharmony during pregnancy and a history of paternal psychiatric problems were also associated with later childhood behavioural difficulties. Children who scored below average on the McCarthy scales of cognitive abilities were also reported by their mothers to have more behavioural problems, but the children's behavioural difficulties at four showed no clear links with post-natal depression.
Information about perceptions of labour and delivery and about immediate emotional reactions to their newborn babies was obtained from two groups of primiparous women (n = 112 and n = 41) and from 40 multiparae. About 40 per cent of primiparae and 25 per cent of multiparae recalled that their predominant emotional reaction when holding their babies for the very first time had been one of indifference. Maternal affection was more likely to be lacking after delivery if the mother had had a forewater amniotomy and had, in addition, either experienced a painful and unpleasant labour or been given more than 125 mg of pethidine. Most mothers developed affection for their babies within a week of delivery and, in all groups of subjects, no longer term adverse effects were seen, such as post-natal depression or aggressive impulses directed at the baby. Three months post-natally it was, however, found that a mother was more likely to express feelings of dislike or indifference towards her baby if she was clinically depressed at the time.
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