Co-occurring maternal emotional well-being and lifestyle profiles from pregnancy to postpartum and offspring developmental outcomes: A prospective cohort study.

Maternal emotional well-being and lifestyle behaviors co-occur during the perinatal period, yet most studies examine them separately. Using data collected since 2019 from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan, a prospective cohort of 539 mother-child dyads, we assessed maternal depressive symptoms, eudaimonic well-being, fruit and vegetable intake, physical activity, and sleep duration from early pregnancy to 2 years postpartum. Group-based multi-trajectory modeling identified co-occurring maternal profiles. Birth weight was analyzed with multiple linear regression, and repeated measures of child attention, aggression, internalizing symptoms, and suspected language delay (ages 2-5 years) with generalized estimating equations, adjusting for covariates. Four perinatal profiles emerged: holistic flourishing (perinatal-HF), lower behavioral engagement, higher well-being (perinatal-LBE-HWB), higher behavioral engagement, lower well-being (perinatal-HBE-LWB), and high-risk (perinatal-HR). Relative to perinatal-HF, the perinatal-HR profile was associated with higher attention problems (aβ = 0.75; 95% CI, 0.35-1.16), aggression (aβ = 5.34; 95% CI, 3.85-6.83), internalizing problems (aβ = 5.65; 95% CI, 4.12-7.19), and suspected language delay (AOR = 2.38; 95% CI, 1.23-4.61). Notably, mothers with preserved emotional well-being but lower behavioral engagement showed comparatively favorable child outcomes. In contrast, mothers with lower emotional well-being showed elevated child behavioral risk despite healthier behaviors. Distinct co-occurring maternal profiles were differentially associated with offspring development, supporting multidomain perinatal screening and interventions that prioritize maternal emotional well-being.