Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study.
Considerable attention has been focused on women's mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR) = 3.46, 95 % confidence interval (CI) = 2.21-5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR = 2.07, 95 % CI = 1.18-3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum.
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia. hannah.woolhouse@mcri.edu.au.
Hannah
H
Woolhouse
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia.
Deirdre
D
Gartland
Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia.|Department of Pediatrics, University of Melbourne, Melbourne, Australia.
Fiona
F
Mensah
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia.
Rebecca
R
Giallo
Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, WL5 Royal Childrens Hospital, Flemington Road Parkville, Victoria, 3052, Australia.|General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia.
Stephanie
S
Brown
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002675:Child, Preschool; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D019052:Depression, Postpartum / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D018730:Infant Behavior / Q000523:psychology*; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013694:Temperament
Child behaviour; Child mental health; Maternal depression; Screening