Impact of trajectories of maternal postpartum depression on infants' socioemotional development

Gireesh Kumar Subbiah; Sijmen A Reijneveld; Catharina A Hartman; Angarath I van der Zee-van den Berg; Magda M Boere-Boonekamp; Josué Almansa; Marlou L A de Kroon

doi:10.1038/s41390-023-02697-w

Impact of trajectories of maternal postpartum depression on infants' socioemotional development

Pediatr Res. 2023 Jun 19. doi: 10.1038/s41390-023-02697-w. Online ahead of print.

Authors

Gireesh Kumar Subbiah¹, Sijmen A Reijneveld², Catharina A Hartman³, Angarath I van der Zee-van den Berg⁴, Magda M Boere-Boonekamp⁵, Josué Almansa², Marlou L A de Kroon^{2

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Affiliations

¹ Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713GZ, Groningen, the Netherlands. g.k.subbiah@umcg.nl.
² Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713GZ, Groningen, the Netherlands.
³ Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
⁴ Netherlands School of Public and Occupational Health, P.O. Box 20022, 3503 LA, Utrecht, the Netherlands.
⁵ Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands.
⁶ Department of Public Health and Primary Care, Environment and Health, KU Leuven, Kapucijnenvoer 35, P.O. Box 7001, 3000, Leuven, Belgium.

PMID: 37337109
DOI: 10.1038/s41390-023-02697-w

Abstract

Background: We assessed (a) the effects of postpartum depression (PPD) trajectories until 6 months postpartum on infants' socioemotional development (SED) at age 12 months, and (b) the mediating role of maternal self-efficacy (MSE), and the additional effect of postpartum anxiety at age 12 months.

Methods: We used data from POST-UP trial (n = 1843). PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 1, 3, and 6 months. Infants' SED was assessed at 12 months using the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE). Structural equations were applied to estimate the effect of PPD trajectories on infants' SED and mediation by MSE. The additional effects of postpartum anxiety were assessed with conditional regression.

Results: Higher levels of PPD over time were associated with a lower SED (coefficient for log-EPDS 3.5, 95% confidence interval 2.8; 4.2, e.g., an increase in the EPDS score from 9 to 13 worsens the ASQ-SE by 1.3 points). About half of this relationship was mediated by MSE. Postpartum anxiety had an independent adverse effect on SED.

Conclusions: PPD and postpartum anxiety have a negative impact on infants' SED. MSE as a mediator may be a potential target for preventive interventions to alleviate the negative effects of maternal psychopathology on infants' SED.

Impact: The trajectories of postpartum depression (PPD) from 1 month to 6 months were negatively related to infants' socioemotional development (SED) at age 12 months, underlining the importance of repeated assessment of PPD. Maternal self-efficacy (MSE) mediated the association between PPD and SED, implying MSE could be a potential target for preventive interventions. An additional independent negative effect of postpartum anxiety was identified, implying the assessment of postpartum anxiety also has a surplus value to identify mothers at risk.