Maternal mental health mediates the effect of prenatal stress on infant temperament: The Harvey Mom Study.

Prenatal maternal mental health symptoms predict infant leptin at birth

BackgroundDespite the high rates and detrimental consequences of co-occurring intimate partner violence (IPV) and offspring child maltreatment (CM), research regarding their potential spillover mechanisms is scarce. This study aims to examine the relation between IPV and CM and the potential mediating roles of maternal depression, anxiety and stress symptoms as well as children´s externalizing behavior problems. Within this model, the potential moderating effect of mothers' own history of CM in the link between IPV and maternal depression, anxiety and stress symptoms is investigated.MethodsIn this cross-section and longitudinal study, an Eastern European sample of 701 mothers (Mage = 35.5; range 21 – 52) with children aged 2–9 years completed a battery of self-report questionnaires at three timepoints (baseline, after 7 and 11 months). Mothers reported on IPV victimization (Conflict Tactics Scale), offspring CM (ISPCAN Child Abuse Screening Tool), maternal mental health symptoms (Depression Anxiety Stress Scales), and children’s externalizing behavior problems (Child Behavior Checklist). Path models were used to test indirect and moderated indirect effects.ResultsCross-sectionally, maternal mental health and child externalizing behavior partially mediated the effect of IPV on CM. Results could not be replicated when using longitudinal data. Maternal history of CM did not moderate the strength of the association between IPV and maternal mental health problems.ConclusionsCross-sectional findings implicate that maternal and child mental health problems, as well as the mother’s own history of CM, seem to be key players in the cycle of violence. Findings may encourage practitioners to target more than one outcome when implementing early interventions for preventing mental health problems or reducing family violence.Trial registrationNCT03865485 registered in ClinicalTrials.gov on March 5, 2019.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24955-8.

The authors examined the association of maternal mental health symptoms and symptom clusters with the sleeping behaviors of toddlers living in low-income homes. The sample is comprised of 174 racially diverse mother and toddler (15–19 months old) dyads who were participating in a longitudinal birth cohort study. Dyads were initially recruited from Women, Infant, and Children clinics in a Midwestern county of the United States. Maternal mental health symptoms were measured with self-reports of depression (Center for Epidemiological Studies–Depression), parenting stress (Parenting Stress Index Very Short Form), and parenting self-efficacy. Toddler sleeping behaviors were measured with an adaptation of the Tayside Children’s Sleep Questionnaire that assessed toddler difficulties in initiating or maintaining sleep (DIMS). Maternal mental health symptom clusters were identified with latent profile analysis and toddler DIMS were regressed on maternal mental health symptoms. We found that 1 SD worse maternal depression, parenting stress, or parenting self-efficacy predicted 0.18–0.24 SD worse toddler DIMS (p < .05). Moreover, we found that the cluster of adverse maternal mental health symptoms predicted nearly 0.75 SD worse toddler DIMS as compared with the cluster of good maternal mental health symptoms (p < .05). These findings provide insight into how maternal mental health symptom clusters may be important in understanding sleep behaviors in early toddlerhood, a sensitive period of sleep development, and underscore the need to support mothers with co-occurring adverse mental health symptoms, as their children may be at higher risk for DIMS.

Parents living in low-income contexts shouldered disproportionate hardships during the COVID-19 pandemic with consequences to maternal mental health and child adjustment. The current study uses a sample of first-time mothers (N = 147) of young toddlers, all living in low-income contexts, to examine the roles of pre-pandemic and COVID-19-specific risk and individual resilience factors in the prediction of changes to maternal mental health coinciding with the onset of the pandemic. Maternal mental health symptoms, in turn, were examined as predictors of child adjustment problems across 6 months of the pandemic and as a potential mechanism conferring pandemic risks to children. While pre-pandemic cumulative contextual risk (i.e., low income, single parent status, adolescent parent status, financial instability) did not predict changes in maternal mental health from prior to during the pandemic, COVID-19-specific health risks predicted changes in maternal mental health from before the pandemic, as well as across 6 months of the pandemic. Regarding individual resilience factors to changes in maternal mental health, pre-pandemic self-compassion predicted better maternal mental health during the pandemic, as did COVID-19-specific appraisal and coping strategies. In turn, maternal mental health predicted children’s early pandemic levels of adjustment problems and changes in adjustment problems across 6 months of the pandemic, with maternal mental health serving an indirect pathway of COVID-19-specific health risks to children’s adjustment. The findings highlight pathways of risk and resilience during a global health crisis and point to targets for interventions in community level crises to promote maternal and child mental health.

Perinatal mood and anxiety disorders can have far reaching negative impact on both maternal mental health and child growth and development. Multimodal group parenting programs have been shown to improve maternal mental health symptoms however, they are often costly to provide and not accessible to many mothers, especially those mothers suffering from mental health symptoms. Therefore, the authors sought to answer the following question by undertaking a systematic review of the literature: are parenting interventions aimed at improving maternal-child interaction also a way to address mental health symptoms (i.e. depression, anxiety, stress) in mothers? The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. An online platform that supports the systematic review process and quality assessment according to Cochrane guidelines, Covidence, was used in conjunction with an adapted extraction tool to identify relevant studies and extract data for analysis. 11 articles were included in the qualitative synthesis. There was great heterogeneity between study interventions and measurement of outcomes for maternal mental health symptoms which precluded meta-analysis. Studies reviewed did not demonstrate consistent evidence to recommend that parenting interventions leads to improvement in maternal mental health symptoms for depression, anxiety or stress. However, there was evidence that participating in parenting programs does not worsen these symptoms and some encouraging evidence that alternative delivery methods, beyond face to face, could, with more research, lead to more financially feasible and sustainable models of delivery of these types of interventions in the future.

ObjectivesThe aim of this study was to assess the association of antenatal maternal dietary patterns (DPs) and other health aspects with infant temperament in a large multiethnic cohort, taking maternal...

Childhood sleep problems are associated with insufficient parental sleep and adverse maternal mental health symptoms, which may be exacerbated when mothers/toddlers co-sleep (i.e., bed/room sharing). This study examines maternal sleep duration as a mechanism linking perceived toddler sleep problems with maternal mental health and examines whether these associations vary by co-sleeping, in addition to exploring alternative models. Low-income mothers of toddlers (n = 280) (age 12-32 months) recruited from Women, Infants, and Children and pediatric clinics provided demographic information and completed questionnaires on their toddler's sleep and their own sleep duration and mental health symptoms (depressive symptoms, anxiety, and stress). Indirect and conditional indirect models were conducted to examine the relation between perceived toddler sleep problems and maternal mental health. Perceived toddler sleep problems were associated with an average decrease of 51 minutes in maternal sleep when co-sleeping (mean = 6.1 h). Maternal sleep duration mediated the relation between perceived toddler sleep problems and maternal symptoms of depression, anxiety, and stress for co-sleeping mothers. Maternal sleep duration did not mediate relations between maternal mental health symptoms and perceived toddler sleep problems. This study provides a conceptual model by which parent and child sleep is related to parental mental health. Practitioners might consider alternatives to co-sleeping when discussing sleep arrangements with parents. Future studies should replicate results longitudinally and examine whether reducing co-sleeping improves maternal sleep duration and reduces perceptions of toddler sleep problems.

For mother-infant health especially, the pandemic has brought multiple stressors inside a susceptible psychobiological system. We study the longitudinal associations between maternal prenatal and postpartum: (a) COVID-19 stressful events exposure, (b) pandemic psychological stress, and (c) mental health and infants' negative affect. A sample of 643 Italian pregnant women completed a web-based survey from April 8th to May 4th, 2020 and a follow-up at 6 months after delivery. Maternal assessment covered prenatal and postpartum measures for: COVID-19 stressful events exposure, pandemic psychological stress, mental health symptoms (i.e., depression, anxiety, posttraumatic stress disorder) and postpartum, social support and report of infants' negative affect. Maternal mental health symptoms during pregnancy, at the peak of pandemic, is longitudinally associated with infant negative affect, with postpartum mental health mediating this association. Also, maternal COVID-19 stressful events exposure in postpartum is associated with negative affect at 6 months mediated by postpartum mental health symptoms. Maternal pandemic psychological stress during pregnancy predicted mental health symptoms in postpartum. The study supports the association between pandemic-related maternal health across pregnancy and postpartum and offspring's development (i.e., negative affect). It also puts the spotlight on mental health risk in women experiencing lockdown during pregnancy, especially when feeling high psychological stress in pregnancy or when directly exposed to COVID-19 stressful events postpartum.

Aims: As the climate crisis escalates, pregnant women are increasingly exposed to extreme weather events, such as heatwaves and floods, which may lead to psychological distress and adverse mental health outcomes for both mothers and infants. This scoping review synthesizes research on the direct and indirect effects of climate change-related stressors on maternal mental health, identifying key trends, interventions, and mitigative strategies. Emphasis is placed on socioeconomic disparities in both high- and low-income countries, as these groups are disproportionately affected.Methods: A systematic search was conducted to identify studies focusing on mental health, pregnancy (pre-, during, post-), and climate change, as defined in the AR6 Climate Change 2023 Synthesis Report, published up to October 2024. Data extraction included study design, population, interventions/exposures, outcomes, and socioeconomic implications. Only original articles and preprints in languages translatable to English were considered.Results: The initial search retrieved 675 articles, of which 14 met the inclusion criteria. Two studies were from middle-income countries (Egypt and Turkey), while the remainder came from high-income countries (Australia, Canada, and the USA). The studies examined climate-related exposures, such as hurricanes, flooding, and extreme heat. Key findings indicate that acute exposure to high temperatures was associated with an increase in psychiatric emergency visits among pregnant women. Similarly, prenatal stress from natural disasters (e.g., hurricanes) was linked to higher levels of maternal mental health symptoms (e.g., depression, PTSD) and changes in infant temperament. Socioeconomic vulnerability played a critical role, with middle-income regions facing greater healthcare barriers, fewer mental health resources, and economic instability. Even in high-income regions, marginalized populations (e.g., Puerto Rico and the US Virgin Islands) experienced healthcare disruptions and prolonged recovery following climate disasters.Conclusion: While the findings highlight the intersection of climate change and maternal mental health, several studies were limited by small sample sizes and reliance on self-reported data. A significant gap exists, as no studies specifically focused on maternal mental health in low-income countries affected by climate change were found during the literature search. Socioeconomic disparities strongly influenced mental health outcomes, underscoring the urgent need for equitable healthcare policies, financial support systems, and culturally adapted interventions. The review calls for the integration of climate resilience strategies into maternal healthcare and the strengthening of mental health infrastructure in low- and middle-income settings. Future research must prioritize longitudinal studies, policy-driven interventions, and targeted support for vulnerable populations.

Postpartum, low-income mothers are at risk for mental health symptoms and obesity, and disordered eating attitudes may be associated with both mental health and obesity in this vulnerable population. The study objective is to determine whether higher levels of mental health symptoms are associated with increased odds of emotional and restrained eating attitudes in this sample of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participants. Data on 711 mothers of infants <13 months from a statewide sample of Maryland WIC participants were collected via telephone survey. Maternal mental health symptoms were measured on continuous scales for depression (PRIME-MD), stress (Perceived Stress Scale) and anxiety (Spielberger State-Trait Anxiety Inventory). Emotional and restrained eating attitudes were measured with questions adapted from the Dutch Eating Behavior Questionnaire. Multivariate logistic regression analysis was used. Obesity [body mass index (BMI) ≥ 30] was explored as a moderating variable. Mothers reporting higher levels of depression symptoms [odds ratio (OR) = 3.93, 95%CI: 2.71-5.69], anxiety symptoms (OR = 1.96, 95%CI: 1.47-2.65), stress symptoms (OR = 2.09, 95%CI: 1.67-2.61) and high overall mental health symptomatology (OR = 3.51, 95%CI: 2.43-5.3) had increased odds of emotional eating attitudes. There were significant associations between symptoms of depression (OR = 1.59, 95% CI: 1.12-2.25) and increased odds of restrained eating attitudes. Obesity did not moderate the association. Mothers with mental health symptoms are at risk for disordered eating attitudes, which may increase risk of poor diet. These findings underscore the need for greater focus on addressing maternal mental health status and eating attitudes in the postpartum period.

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (MAGE = 3.7, SD = 1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β = 0.09, p < 0.01). In addition, there was a direct effect of maternal trauma symptoms on children’s behavior problems (β = 0.32, p < 0.001). The results suggest that maternal trauma symptoms, in addition to maternal depressive symptoms, contribute to poor maternal and child functioning.

Prenatal maternal stress can have a profound and enduring influence on child development. This represents an important public health issue and signals a need for intervention. However, despite an accumulating number of empirical studies, several key questions about the effects of prenatal maternal stress remain unanswered: 1) Few studies have focused on motor development, even though it is foundational for development across a range of other areas; 2) Research on mechanisms of transmission has focused on physiological processes, such as cascades of stress related hormones, and largely ignored the psychological cascades that can drive these underlying physiological responses; 3) Many prenatal stress studies only measure child development at one point in time, which provides information about the emergence of effects but cannot answer important questions about progression; and 4) Very few prenatal stress studies have looked at variables that can explain or reduce negative effects, which is essential information for effective intervention. This thesis investigates the relationship between different aspects of disaster-related prenatal maternal stress and child motor development, explores how stress reactions work together to predict motor development, and proposes a cascade of stress reactions as a psychological mechanism of transmission for the effects of prenatal maternal stress. It examines continuity and change in findings between 16 and 30 months and, finally, looks at whether maternal coping predicts child motor development. At recruitment, mothers (N = 224) exposed to a major flood during pregnancy completed questionnaires assessing flood exposure (QFOSS), peritraumatic distress (PDI) and dissociation (PDEQ), posttraumatic stress (IESR), a cognitive appraisal of the overall flood consequences, and coping (BriefCOPE). At 16 months (N = 145) and 30 months (N = 150) post-partum, children’s fine and gross motor development was assessed using the Bayley-III, and mothers completed questionnaires assessing postnatal stressors (i.e., life events, parenting stress and mental health). At 16 months, higher maternal posttraumatic stress predicted poorer child fine motor development and negative cognitive appraisal predicted poorer gross motor development. Both effects were only significant for children exposed to the flood from mid-gestation onwards. At 30 months, higher maternal posttraumatic stress again predicted poorer child fine motor development, but the relationship between cognitive appraisal and gross motor development was no longer evident. In addition, two new effects emerged: higher maternal dissociation predicted poorer child gross motor development, and flood exposure later in gestation predicted better gross motor development. Cascades of maternal stress reactions linked flood exposure to poorer child motor development, with different mechanisms for fine and gross motor development. Coping strategies predicted motor development indirectly via maternal stress. Both positive and negative effects were evident, depending on the type of coping strategy. Overall, this thesis makes several important contributions. It extends the current literature by establishing that different types of prenatal maternal stress can predict different areas of motor development in early childhood. It proposes potential psychological mechanisms of transmission for the effects of prenatal maternal stress on motor development, and provides further evidence that the effects of prenatal maternal stress can be enduring. It is also suggests that maternal coping indirectly predicts child development by influencing maternal stress. These findings have implications for the design of prenatal stress research, and for guiding interventions with pregnant mothers in the wake of natural disasters.

Hats Off: Journal Awards 2018

BackgroundInfant temperament predicts a range of developmental and behavioral outcomes throughout childhood. Both maternal fatty acid intake and psychosocial stress exposures during pregnancy may influence infant temperament. Furthermore, maternal race may modify prenatal diet and stress effects. The goals of this study are to examine the joint effects of prenatal diet and stress and the modifying effects of race on infant behavior.MethodsAnalyses included N=255 mother-infant dyads, primarily minorities (21% Blacks; 42% Hispanics), enrolled in an urban pregnancy cohort. Maternal prenatal stress was indexed by a negative life events (NLEs) score on the Crisis in Family Systems-Revised survey. Prenatal total daily intakes of polyunsaturated fatty acids (PUFAs) (n3, n6) were estimated from a food frequency questionnaire; n3:n6 ratios were calculated. Mothers completed the Infant Behavior Questionnaire-Revised (IBQ-R), a measure of infant temperament, when the children were 6 months old. Three commonly used dimensions were derived: Orienting & Regulation, Extraversion, and Negative Affectivity. Associations among prenatal stress, maternal n3:n6 ratio, and race/ethnicity on infant temperament, controlling for maternal education and age and child sex, were examined.ResultsAmong Blacks, prenatal stress effects on infant Orienting & Regulation scores were modified by maternal n3:n6 ratios (p=0.03): As NLEs increased, lower n3:n6 ratios predicted lower infant Orienting & Regulation scores, whereas higher n3:n6 ratios attenuated the effect of prenatal stress. There were no main or interaction effects predicting Extraversion or Negative Affectivity.ConclusionsAn optimal PUFA ratio may protect the fetus from stress effects on infant behavior, particularly among Blacks. These findings may have implications for later neurodevelopment and social functioning predicted by early temperamental characteristics.

DNA methylation as a mediator in the association between prenatal maternal stress and child mental health outcomes: Current state of knowledge