title: A prospective study of maternal anxiety, perceived stress, and depressive symptoms in relation to infant cognitive development.
abstract: OBJECTIVE
  Our objective was to examine the associations between maternal psychological health (trait anxiety, perceived stress, and depressive symptoms) during pregnancy or postpartum and infant visual, language, motor, and overall cognitive development.
  
  
  METHODS
  In the prospective Pregnancy, Infection, and Nutrition Study (2001-2006), central North Carolina women completed self-administered questionnaires during pregnancy to assess trait anxiety and depressive symptoms. An in-person interview assessed maternal perceived stress and depressive symptoms in the 4th postpartum month. Infant development was assessed at 12 months using the Mullen Scales of Early Learning (n=358). Multiple linear regression with restricted cubic splines was used to examine potential non-linear associations between trait anxiety, perceived stress, and depressive symptoms in relation to Mullen sub-scales and Composite scores.
  
  
  RESULTS
  Increasing maternal anxiety was associated with poorer overall cognition (adjusted β for Composite=-0.2, 95% CI: -0.4, 0.0). Postpartum stress was positively associated with language development and general cognition (adjusted β for Expressive Language=0.2, 95% CI: 0.0, 0.4; adjusted β for Composite=0.3, 95% CI: 0.0, 0.6). Elevated depressive symptoms throughout pregnancy and postpartum were associated with better fine motor skills (adjusted β=9.7, 95% CI: 3.9, 15.5). Anxiety, postpartum depressive symptoms and stress were associated with gross motor skills in a non-linear fashion, as were postpartum depressive symptoms and stress with expressive language.
  
  
  CONCLUSIONS
  Maternal trait anxiety, depressive symptoms and stress had little negative influence on infant cognitive development. In fact, moderate psychosocial distress may slightly accelerate motor development in particular, and some aspects of language.
authors.affiliation: University of North Carolina at Chapel Hill, Department of Epidemiology, Chapel Hill, NC, United States. Sarah.keim@nationwidechildrens.org
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Keim
authors.forename: Julie L
authors.initials: JL
authors.lastname: Daniels
authors.forename: Nancy
authors.initials: N
authors.lastname: Dole
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: Peter C
authors.initials: PC
authors.lastname: Scheidt
mesh_terms: D001007:Anxiety / Q000523:psychology*; D002657:Child Development / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007802:Language; D016014:Linear Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D009048:Motor Skills / Q000502:physiology; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014796:Visual Perception / Q000502:physiology