Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic

Abstract

It remains unclear how the COVID-19 pandemic has affected the mother–infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother–infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother–infant relationship. Maternal PPD was associated with more infant negative affectivity and mother–infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.

Differences in infant negative affectivity during the COVID‐19 pandemic

“…Overall, these findings are consistent with previous work finding associations between maternal distress and infant socioemotional development during the COVID‐19 pandemic (Bianco et al., 2022; Chang et al., 2023; Duguay et al., 2022; Provenzi, Grumi et al., 2021). However, there is some inconsistency in the literature with respect to the association between maternal distress during the pandemic and specific domains of infant temperament (i.e., negative affectivity, surgency, effortful control).…”

“…However, there is some inconsistency in the literature with respect to the association between maternal distress during the pandemic and specific domains of infant temperament (i.e., negative affectivity, surgency, effortful control). These findings are consistent with research showing that postpartum depression symptoms in women seeking mental health support during the pandemic were associated with more infant negative affectivity ( Chang et al, 2023 ) and that maternal COVID-19 impact score was related to infant negative emotionality ( Bianco et al, 2022 ). However, other studies have found relationships between maternal distress and infant surgency, but not infant negative affectivity ( Provenzi, Mambretti, et al, 2021 ).…”

“…Counter to this finding, another study found that mothers with higher postpartum stress rated their infants as having lower surgency and regulation at 3 months postpartum, even though they did not find differences in infant temperament based on maternal SARS-CoV-2 infection ( Bianco et al, 2022 ). Similarly, a 2023 study found that, in women seeking mental health support both before and during the COVID-19 pandemic, postpartum depressive symptoms were associated with more infant negative affectivity, but that that pandemic exposure did not appear to moderate this relationship ( Chang et al, 2023 ). The inconsistency in these findings may be due to differences in the timing of stress measurement, which is further complicated by the retrospective report of maternal stress in the MOM-COPE project.…”

COVID‐19 pandemic effects: Examining prenatal internalizing symptoms and infant temperament

“…However, given that in many respects this investigation is first of a kind, we prioritized controlling Type 2 error to maintain adequate power. This approach is typical for investigations addressing temperament with similarly sized samples (Balle et al., 2022; Blandon et al., 2010; Zhang et al., 2018) and the influence of pandemic stress on maternal‐child health (Chang et al., 2023; Morales et al., 2021; Morris & Saxbe, 2023; Sacchi et al., 2023). Nonetheless, future studies are needed to follow‐up and discern the most robust pathways of the COVID‐19 pandemic on prenatal mental health and infant temperament.…”

The Functioning of Offspring of Depressed Parents: Current Status, Unresolved Issues, and Future Directions

“…Buthmann et al (2022) found that pandemicrelated stress was associated with both increased prenatal depressive symptoms and infant negative affect. Comparing women who became mothers before versus during the pandemic, Chang et al (2023) found that the association between postpartum depression and maternal anxiety about the child was stronger during than before the pandemic; further, parental bonding mediated the relation between postpartum depression and infant negative affect across both samples. The COVID-19 pandemic may have also exacerbated associations between parent depression and child mental health.…”