Fransson, E., Sörensen, F., Ramklint, M., Eckerdal, P., Krägeloh-Mann, I., & Skalkidou, A. (Submitted). Maternal Trajectories of Perinatal Depressive Symptoms: Impact on Toddler Behavior – The Importance of Symptom Onset, Duration and Maternal Bonding.
Maternal perinatal depression is a common public health problem affecting mothers and children worldwide. This study aimed to increase the knowledge regarding maternal depression trajectories and early child behavioral difficulties, and assessing the impact of child gender and maternal bonding.
Data were drawn from a population-based BASIC and UBIRTH mother-infant study (n=1353). Linear regression models were utilized for the association between maternal depression trajectory; antenatal depression, postpartum depression, both antenatal and postnatal depression/persistent perinatal depression and non-depressed, based on longitudinal ratings on the Edinburgh Postnatal Depression Scale (EPDS) and child behavioral problems assessed with the Child Behavior Check List (CBCL) at 18 months. The analyses were repeated after stratification for gender. A path analysis was applied to assess the mediating role of maternal bonding.
Children with mothers following antenatal and persistent depression trajectories had higher scores (Total, Internalizing and Externalizing problems) on the CBCL, after adjusting for confounding factors. The stratified regression modeling, showed that girls were affected at a greater degree. Postpartum bonding mediated most of the negative effects of postpartum and persistent but not antenatal depression on child behavior.
The results indicate an effect of antenatal depression on fetal programming but also a substantial mediating effect of maternal bonding postpartum.