Prenatal symptoms of anxiety and depression associated with sex differences in both maternal perceptions of one year old infant temperament and researcher observed infant characteristics

K Savory,S.M Garay,L.A Sumption,J.S Kelleher,K Daughters,A.B Janssen,S Van Goozen,R.M John

doi:10.1016/j.jad.2019.11.057

Abstract

BackgroundSex differences in the behaviour of children exposed to prenatal maternal depression and anxiety have been reported. This study compared depression and anxiety symptoms reported by mothers at term with maternal perceptions of one year old male and female infant temperament and with researcher observed infant characteristics, identifying differences for males and females with both approaches. MethodsInfant behaviour and temperament was assessed via maternally completed questionnaires including Infant Behavioural Questionnaire Revised – Short form and by researcher administered subcomponents of Laboratory Temperament Assessment Battery and Bayley Scales of Infant Development III. ResultsFor female infants, higher prenatal scores for depression and anxiety were associated with maternal perceptions of lower bonding, higher aggression and negativity, and lower soothability (n = 67 mother-infant dyads). In the laboratory assessment, intensity of escape was the only female infant factor significantly associated with maternal mood (n = 41). For male infants, there was minimal association between prenatal mood scores and maternal perceptions (n = 46) whereas in the laboratory assessment (n = 35) depression scores were associated with expressive language, facial interest and facial fear while anxiety scores were associated with expressive and receptive language, parent behaviour and facial fear. LimitationsFindings may be restricted to a single ethnicity or mode of delivery. Fewer infants attended the infant assessment. A laboratory setting may mask symptomatology in females. ConclusionsAtypical maternal perceptions may present a barrier to the early identification of male infants impacted by maternal depression and anxiety.

Highlights

One in seven pregnancies are impacted by maternal depression and over one quarter are impacted by concerning levels of anxiety (Heron et al, 2004; Janssen et al, 2018; Lockwood Estrin et al, 2019)
Recruitment was undertaken by two trained research midwives at the University Hospital of Wales (UHW) between 1st September 2015 and 31st November 2016 at a presurgical appointment prior to a booked elective caesarean section (ELCS) if they met the criteria of a singleton term pregnancy without fetal anomalies and infectious diseases
Partial correlations were utilised to assess the relationship between maternally reported depression and anxiety symptoms reported just prior to a term delivery and maternally reported mood symptoms one year later, infant bonding and infant outcomes, controlling for infant age at questionnaire completion (Table 2)

Summary

Introduction

One in seven pregnancies are impacted by maternal depression and over one quarter are impacted by concerning levels of anxiety (Heron et al, 2004; Janssen et al, 2018; Lockwood Estrin et al, 2019). Studies exploring the relationship between maternal mood symptoms and outcomes generally control for sex in the analysis and aim to have an equal representation of males and females. This approach may obscure sex-specific findings adding further complexity. There was minimal association between prenatal mood scores and maternal perceptions (n = 46) whereas in the laboratory assessment (n = 35) depression scores were associated with expressive language, facial interest and facial fear while anxiety scores were associated with expressive and receptive language, parent behaviour and facial fear. Conclusions: Atypical maternal perceptions may present a barrier to the early identification of male infants impacted by maternal depression and anxiety

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