Maternal Depression During Pregnancy and the Postnatal Period

Abstract

IMPORTANCE Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention.OBJECTIVE To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. DESIGN, SETTING, AND PARTICIPANTSProspective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring.MAIN OUTCOMES AND MEASURES Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision.RESULTS Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression. CONCLUSIONS AND RELEVANCEThe findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.

Maternal depressive symptoms have a negative impact on prenatal attachment – findings from a Swedish community sample

“…This is an important finding and supports the work of Flykt et al (2010), who reported that prenatal depression has a negative effect on attachment between mother and baby with prenatal depressive symptoms having a stronger impact on maternal unresponsiveness with her infant than postnatal depressive symptoms. Depressive symptoms are well known to have a significant impact on a pregnant woman's quality of life (Cohen & Nonacs, 2005) and can impact negatively on her family's health particularly including major depression of her children at age 18 years (Pearson et al, 2013). While there has been some discussion in the literature regarding prenatal depression and subsequent poor attachment in the postnatal period, the linkage between prenatal depression and prenatal attachment has been largely uninvestigated.…”

Repetitive Negative Thinking and Its Role in Perinatal Mental Health

“…The long-term consequences of maternal postnatal depression for the child are profound, in light of the documented link with the emergence of depression [2] and other psychiatric disorders [3] in offspring. Post-partum anxiety is also common, although it has been far less studied than has depression [4, 5].…”

Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms

“…With regard to early family risk factors, maternal depressive symptoms (pre‐ and postnatal) are robust and well researched risks for offspring depressive symptoms in adolescence (Pawlby, Hay, Sharp, Waters, & O'Keane, 2009; Pearson et al., 2013) and may act as a common antecedent of the three pathways outlined above (i.e. Irritability Symptoms ; Anxiety/Depressive Symptoms ; and Conduct Problems; Cents et al., 2013; Leis, Heron, Stuart, & Mendelson, 2014; Mars et al., 2012).…”