Parent–child interaction, maternal depressive symptoms and preterm infant cognitive function

Abstract

Preterm infants are at risk for cognitive difficulties due to infant neurological immaturity and family social disadvantage, and this may be exacerbated by maternal depressive symptoms. This longitudinal study of infants born preterm (<35 weeks) or low birth weight (<2500g) (n=137) tests if maternal depressive symptoms at 4 months is associated with preterm children's cognitive function at 16 months. Additionally, we test if this association is mediated by the quality of parent–child interaction at 9 months, and if these associations differ by levels of maternal social support. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd edition. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Perceived social support was measured using the Maternal Support scale. The quality of parent–child interaction was measured using the Parent–Child Early Relational Assessment. Linear regression and structural equation modeling were used to test the research questions. Postnatal depression at 4 months is associated with lower cognitive function (mean difference=−5.22, 95% CI: [−10.19, −0.25]) at 16 months controlling for a host of socioeconomic characteristics. For mothers with fewer depressive symptoms, bolstering effects of maternal supports on children's cognitive function were evident. We find no evidence for effect mediation by quality of parent–child interaction. Early exposure to maternal depressive symptoms appears to have a negative influence on preterm children's later cognitive function. These findings suggest important policy and programmatic implications for early detection and intervention for families of preterm infants.