Early maternal depressive symptoms and child developmental outcomes at six years old: a prospective birth cohort study in a low-risk population.

BACKGROUND

This study aimed to identify distinct trajectories of maternal depressive symptoms from late pregnancy to 36 months postpartum and to assess their associations with children's emotional, behavioral, and cognitive outcomes.

METHODS

We analyzed data from 240 mother-child dyads in Shanghai from a cohort screened at enrollment to exclude major pre-existing mental disorders and pregnancy complications. Maternal depressive symptoms were assessed in late pregnancy using the Center for Epidemiologic Studies Depression Scale, at 42 days postpartum using the Edinburgh Postnatal Depression Scale, and at 12, 18, 24, and 36 months postpartum using the Depression-Dejection subscale of the Profile of Mood States. Children's emotional, behavioral, and cognitive outcomes were assessed at age 6 years using the Strengths and Difficulties Questionnaire and the Wechsler Intelligence Scale for Children. Group-based trajectory modeling and regression models were constructed.

RESULTS

Four trajectories were identified: stable-low levels of depression (78.8%), maternal depression in the perinatal period (10.0%), maternal depression in the second year postpartum (5.4%), and maternal depression in the third year postpartum (5.8%). Compared with the stable-low group, maternal depression in the perinatal period was associated with more emotional problems in children aged 6 years (β = 0.98, P < 0.05). Maternal depression in the second year postpartum was associated with more conduct problems (β = 1.36, P < 0.001) and lower cognitive proficiency in children aged 6 years (β = - 12.12, P < 0.05).

CONCLUSION

Temporally elevated maternal depressive symptom trajectories from pregnancy to 3 years postpartum were associated with adverse emotional, behavioral, and cognitive outcomes in children.