Examining Associations Between the Timing of Maternal Depressive Symptoms, Parenting Behaviors, and Child Outcomes.

OBJECTIVE

Perinatal depression is associated with poor psychosocial functioning and impaired parent-child relationship quality and confers risk for offspring psychopathology and altered brain structure. This study investigated the relative associations between the timing of perinatal depressive symptoms (prenatal, postnatal, and concurrent) and toddler psychopathology symptoms, toddler brain structure, and parenting behaviors. The study then explored whether parenting behaviors mediated relations between perinatal depressive symptoms and child psychopathology outcomes.

METHOD: Using longitudinal data from 220 pregnant women and singleton offspring in the Early Life Adversity and Biological Embedding Study, associations from the first trimester of pregnancy to 3 years postpartum were examined. Linear mixed effect analyses examined associations between the timing of maternal depressive symptoms and toddler brain and behavioral development. The study also investigated whether maternal depressive symptoms were indirectly associated with psychopathology symptoms of children through parenting behaviors. The data included multiple time points of maternal depressive symptoms (prenatal, early postnatal, late postnatal, and concurrent) and children's outcomes (psychopathology symptoms and brain structure at ages 2 and 3 years), which allowed examination of dynamic associations within dyads.

RESULTS

Higher levels of early postnatal maternal depressive symptoms, exceeding prenatal and concurrent depressive symptoms, were associated with greater externalizing symptoms in toddlers (β = .15, p = .02, q = .05). Nonsupportive parenting behaviors partially mediated these relations (p = .02) and were directly associated with greater externalizing symptoms in children (β = .14, p = .03).

CONCLUSION

Findings suggest temporal differences in the relation of perinatal depressive symptoms to children's psychopathology. Specifically, postnatal maternal depressive symptoms were associated with toddlers' externalizing symptoms. Nonsupportive parenting behaviors partially explained these relations. These results emphasize the importance of early and accessible identification, intervention, and treatment of postnatal depressive symptoms.

PLAIN LANGUAGE SUMMARY: This study aimed to better understand associations between maternal depressive symptoms across the perinatal period and child socioemotional outcomes. Using longitudinal data from 220 pairs of pregnant women and their children, the authors examined associations between the timing of maternal depressive symptoms and toddler brain development and behavior. The authors found that postnatal maternal depressive symptoms were associated with toddlers' externalizing symptoms, and nonsupportive parenting behaviors partially mediated this relationship. Findings highlight the importance of accessible perinatal mental healthcare, including for mothers with subclinical depressive symptoms.

STUDY REGISTRATION INFORMATION: Investigating the Path From Prenatal Depression Through Parenting Behaviors to Offspring Internalizing Problems and Amygdala and Hippocampal Volume; https://osf.io/s3vma.