BMJ Open (Sep 2022)

Postnatal maternal depressive symptoms and behavioural outcomes in term-born and preterm-born toddlers: a longitudinal UK community cohort study

  • Andrew Pickles,
  • Serena Counsell,
  • Ira Kleine,
  • David Edwards,
  • George Vamvakas,
  • Alexandra Lautarescu,
  • Chiara Nosarti,
  • Shona Falconer,
  • Andrew Chew

DOI
https://doi.org/10.1136/bmjopen-2021-058540
Journal volume & issue
Vol. 12, no. 9

Abstract

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Objectives To examine the association between maternal depressive symptoms in the immediate postnatal period and offspring’s behavioural outcomes in a large cohort of term-born and preterm-born toddlers.Design and participants Data were drawn from the Developing Human Connectome Project. Maternal postnatal depressive symptoms were assessed at term-equivalent age, and children’s outcomes were evaluated at a median corrected age of 18.4 months (range 17.3–24.3).Exposure and outcomes Preterm birth was defined as <37 weeks completed gestation. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS). Toddlers’ outcome measures were parent-rated Child Behaviour Checklist 11/2–5 Total (CBCL) and Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores. Toddlers’ cognition was assessed with the Bayley Scales of Infant and Toddler Development—Third Edition (Bayley-III).Results Higher maternal EPDS scores were associated with toddlers’ higher CBCL (B=0.93, 95% CI 0.43 to 1.44, p<0.001, f2=0.05) and Q-CHAT scores (B=0.27, 95% CI 0.03 to 0.52, p=0.031, f2=0.01). Maternal EPDS, toddlers’ CBCL and Q-CHAT scores did not differ between preterm (n=97; 19.1% of the total sample) and term participants. Maternal EPDS score did not disproportionately affect preterm children with respect to CBCL or Q-CHAT scores.Conclusions Our findings indicate that children whose mothers reported increased depressive symptoms in the early postnatal period, including subclinical symptoms, exhibit more parent-reported behavioural problems in toddlerhood. These associations were independent of gestational age. Further research is needed to confirm the clinical significance of these findings.