title: [The relationship between maternal emotional symptoms during pregnancy and emotional and behavioral problems in preschool children: a birth cohort study].
abstract: OBJECTIVE
  To investigate the related influencing factors of preschool children's emotional and behavioral problems in early life and explore the associations between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.
  
  
  METHODS
  Based on the Ma'anshan Birth Cohort Study of the China-Anhui Birth Cohort Study (C-ABCS), women were recruited at their first clinical visit between October 2008 and October 2010 in four municipal medical and health institutions of Ma'anshan City, a total of 5 084 pregnant women and 4 669 singletons live births were included in the birth cohort. Women completed measures of depressive (Self-Rating Anxiety scale) and anxious (Center for Epidemiologic Studies Depression) symptoms in pregnancy. By the age of 3-6 follow-up, 3 653 children were followed with completed information between April 2014 and April 2015, strengths and difficulties questionnaires were used to assessed offspring emotional and behavioral problems. Logistics regression was used to investigate the relationship between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.
  
  
  RESULTS
  The detected rates of emotional symptoms, conduct problems, hyperactivity and peer problems in preschool children were 6.3% (229/3 653), 7.5% (274/3 653), 7.6% (278/3 653) and 2.8% (103/3 653), while 7.6% (277/3 653) for total difficulties, 10.9%(398/3 653) for prosocial behavior and 27.4%(981/3 557) for impact respectively. Prevalence of anxiety and depression in the first trimester was 2.7%(100/3 653) and 4.7%(171/3 653) respectively, and in the second trimester was 2.0%(66/3 375) and 3.6%(122/3 375) respectively. After we controlled the confoundings of gestation age, place of residence, family income, maternal education, paternal education, premature birth and folic acid supplement before pregnancy, multinomial logistic regression analysis showed that the risk of children's emotional symptoms in maternal anxiety in both first-trimester and second-trimester group was higher than the group of no depression and anxiety symptoms, and OR(95%CI) was 5.90(2.00-17.48). Compared with whose mother no depression in both first-trimester and second-trimester, the risk of children's emotional symptoms in maternal depression in both first-trimester and second-trimester group was higher, and OR(95% CI) was 3.07 (1.30-7.28). And the risk of children's total difficulties of maternal anxiety in second-trimester was 2.27 (95%CI: 1.10-4.71) times of no anxiety in second-trimester. While the risk of children's total difficulties of maternal depression in second-trimester was 2.20 (95%CI: 1.24-3.93) times of no depression in second-trimester. Maternal emotional symptoms were not significant associations with conduct problems, hyperactivity, peer problems and prosocial behaviors (P> 0.05).
  
  
  CONCLUSIONS
  There was a negative impact of maternal anxiety and depression symptoms during pregnancy on emotional and behavioral problems in preschool children. These findings highlight the need for additional clinical and research attention to both maternal depression and anxiety in pregnancy, which may be helpful to reduce the incidence of children's emotional and behavioral problems and act as an important measure in prevention.
authors.affiliation: Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University; Anhui Provincial Laboratory of Population Health and Eugenics, Hefei 230032, China.
authors.forename: Huihui
authors.initials: H
authors.lastname: Tao
authors.forename: Ting
authors.initials: T
authors.lastname: Shao
authors.forename: Lingling
authors.initials: L
authors.lastname: Ni
authors.forename: Yanli
authors.initials: Y
authors.lastname: Sun
authors.forename: Shuangqin
authors.initials: S
authors.lastname: Yan
authors.forename: Chunli
authors.initials: C
authors.lastname: Gu
authors.forename: Hui
authors.initials: H
authors.lastname: Cao
authors.forename: Kun
authors.initials: K
authors.lastname: Huang
authors.forename: Fangbiao
authors.initials: F
authors.lastname: Tao
authors.forename: Shilu
authors.initials: S
authors.lastname: Tong
mesh_terms: D001007:Anxiety / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002681:China; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D015995:Prevalence; D000066553:Problem Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires