Maternal mental health and medical predictors of infant developmental and health problems from pregnancy to one year: does former infertility matter?
BACKGROUND
Transition to parenthood involves considerable psychological, social and physiological changes. We examined how prenatal and perinatal mental health and medical conditions predict infant's developmental and health status at 12 months, and whether former infertility and assisted reproduction treatment (ART) affect the predictor model.


METHODS
The participants were 520 mothers who filled in questionnaires at the second trimester of pregnancy (T1), and when the child was 2 months (T2) and 12 months old (T3). Depressive and anxiety symptoms indicate reduced levels of mental health, and medical factors involve problems in pregnancy (e.g., high blood pressure and bleeding) and birth complications (pain and loss of blood). Neonatal health refers to, e.g., birth-weight and neurological status. At 12 months mothers reported infants' verbal and motor development and general health status.


RESULTS
First, it was shown that generally maternal prenatal anxiety and medical problems in pregnancy together predicted infant's developmental problems at 12 months through poor neonatal health, and medical problems alone also through increased level of birth complications. Second, the predictor models differed according to the history of infertility. In the ART group prenatal depression and anxiety and medical problems together predicted infant's developmental problems through maternal post-partum depression, and medical problems also through birth complications, whereas in the spontaneous conception group psychological and medical paths were separated and did not carry on developmental and health problems into 12 months.


CONCLUSIONS
Maternal health care should consider both psychological and medical risk paths across the whole transition to parenthood, and be aware of specific mediating paths in the risk groups.
Punamäki
Raija-Leena
RL
Department of Psychology, University of Tampere, 33014 Tampere, Finland. raija-leena.punamaki@uta.fi
Repokari
Leena
L
Vilska
Sirpa
S
Poikkeus
Piia
P
Tiitinen
Aila
A
Sinkkonen
J
J
Tulppala
Maija
M
D001007:Anxiety / Q000523:psychology; D002657:Child Development; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007247:Infertility, Female / Q000523:psychology*; D008429:Maternal Welfare / Q000523:psychology*; D008603:Mental Health; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011262:Pregnancy Trimester, Second; D011795:Surveys and Questionnaires