Positive maternal mental health during pregnancy and mental and behavioral disorders in children: A prospective pregnancy cohort study

Abstract

Background: The role of positive maternal mental health during pregnancy in child mental health remains largely unknown. We investigated whether positive maternal mental health during pregnancy is associated with lower hazards of mental and behavioral disorders in children and mitigates the adverse effects of negative maternal mental health. Methods: Among 3,378 mother-child dyads of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study, mothers reported their positive mental health biweekly throughout pregnancy with the Positive and Negative Affect Schedule, the Spielberger State Anxiety Inventory Curiosity scale, and a visual analogue scale for social support, and negative mental health with the Center for Epidemiologic Studies Depression Scale. We extracted data on their mental and behavioral disorder diagnoses from a nationwide medical register. This register provided data on their children's mental and behavioral disorder diagnoses as well, from birth until 8.4À12.8 (Median = 10.2, Interquartile Range 9.7À10.8) years of age. Results: A positive maternal mental health composite score during pregnancy was associated with a lower hazard of any mental and behavioral disorder among all children [Hazard Ratio (HR) = 0.79, 95% Confidence Interval (CI) 0.71 À 0.87] and among children of mothers experiencing clinically relevant depressive symptoms during pregnancy [HR = 0.80, 95%CI 0.64 À 1.00] and/or mental and behavioral disorders before or during pregnancy [HR = 0.69, 95%CI 0.55À0.86]. These associations were independent of covariates. Conclusions: Children whose mothers had more positive mental health during pregnancy were less likely to develop mental and behavioral disorders. Protective effects were seen also among children of mothers facing mental health adversities before or during pregnancy.

Commentary: Promoting positive mental health during pregnancy—reflections on Lähdepuro et al. (2023)

“…In conclusion, based on the findings of Lähdepuro et al. (2023) we recommend that research should study both biological and psychological mechanisms underlying the association between positive maternal mental health during pregnancy and child outcomes and invest in the development, optimization, and evaluation of positive mental health increasing interventions during pregnancy, especially for pregnant women with mental health problems. Investing in the promotion of positive maternal mental health during pregnancy concerns a promising public health approach and has the potential to improve maternal perinatal mental health and behavioral and developmental outcomes of future generations.…”

“…Interestingly, positive maternal mental health during pregnancy positively influences the maternal stress response and reduces the risk of developing mental health problems during pregnancy (Kumar et al., 2022; Lähdepuro et al., 2023). Positive mental health may thus represent a source of resilience protecting against the long‐term negative effects of prenatal exposure to maternal mental health problems on the offspring.…”

“…At a socioecological level perceived social support concerns an important resilience‐enhancing factor. Maternal perceived social support during pregnancy protects against the development of depressive symptoms, reduces stress, and can attenuate the negative effects of maternal mental health problems on child behavioral functioning (Kumar et al., 2022; Lähdepuro et al., 2023). A particularly important form of social support during pregnancy is partner social support.…”

“…The recent publication by Lähdepuro et al. (2023) based on a large‐scale pregnancy cohort study ( n = 3,378) reported an association between positive maternal mental health during pregnancy and a reduced risk of developing clinically diagnosed childhood mental and behavioral disorders independent of multiple potential confounders. Beneficial effects of maternal positive mental health were also observed among children of mothers having mental health disorders and symptoms before and during pregnancy.…”

Effects of prenatal subjective well-being on birth outcomes and child development: A longitudinal study

“…For child development in the other hand, parental psychological well-being is associated with health behavior [12] and parenting behavior [13], which may impact child development [14]. For example, prenatal 4 maternal positive mental health was associated with a lower risk of mental illness in children [15] and reduced the effect of maternal stress on children internalizing and externalizing symptoms [16]. In addition, a longitudinal study reported that positive maternal perinatal mental health is associated with more favorable developmental outcomes in toddlers, particularly regarding cognition, communication, and social development [17].…”