Higher Maternal Depressive Symptoms Research Articles

The Impact of Pregnancy Readiness on Lupus Activity, Maternal Mental Health, and Pregnancy Outcomes.

Among individuals with systemic lupus erythematosus (SLE) who became pregnant, we explored the impact of medical readiness for pregnancy and personal readiness for pregnancy on the following aspects of maternal health: (1) provider-reported disease activity, (2) patient-perceived disease activity, (3) mood symptoms, (4) pregnancy-related health behaviors, and (5) pregnancy outcomes. All study participants were enrolled in a prospective registry, met Systemic Lupus Collaborating Clinics (SLICC) criteria for SLE, and had at least one pregnancy. Patient-reported outcomes were collected at the first rheumatology visit during pregnancy. "Medically ready" for pregnancy was defined as (1) <1 g of proteinuria, (2) no rheumatic teratogens at conception, and (3) continuing pregnancy-compatible SLE medications after conception. "Personally ready" was defined as planned pregnancy based on a London Measure of Unplanned Pregnancy score ≥10. Multivariable logistic regression models estimated the association of pregnancy readiness with each outcome of interest. Among the 111 individuals enrolled, lack of medical readiness for pregnancy was associated with significantly higher rates of active disease and worse pregnancy outcomes; however, these patients did not perceive themselves as having higher disease activity. Lack of personal readiness for pregnancy was associated with significantly higher patient-perceived disease activity. Although medical readiness did not impact depressive symptoms substantially, lack of personal readiness for pregnancy was associated with much higher maternal depressive symptoms. To improve pregnancy outcomes among individuals with SLE, greater focus is needed on improving medical optimization before conception. For maternal mental health and quality of life, greater focus is needed on decreasing the incidence of unplanned pregnancy.

Joint effects of prenatal exposure to indoor air pollution and psychosocial factors on early life inflammation

It is hypothesized that air pollution and stress impact the central nervous system through neuroinflammatory pathways Despite this, the association between prenatal exposure to indoor air pollution and psychosocial factors on inflammatory markers in infancy has been underexplored in epidemiology studies. This study investigates the individual and joint effects of prenatal exposure to indoor air pollution and psychosocial factors on early life inflammation (interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)). We analyzed data from the South African Drakenstein Child Health Study (N = 225). Indoor air pollution and psychosocial factor measurements were taken in the 2nd trimester of pregnancy. Circulating inflammatory markers (IL-1β, Il-6, and TNF-α) were measured in serum in the infants at 6 weeks postnatal. Linear regression models were used to investigate associations between individual exposures and inflammatory markers. To investigate joint effects of environmental and psychosocial factors, Self-Organizing Maps (SOM) were used to create exposure profile clusters. These clusters were added to linear regression models to investigate the associations between exposure profiles and inflammatory markers. All models were adjusted for maternal age, maternal HIV status, and ancestry to control for confounding. Most indoor air pollutants were positively associated with inflammatory markers, particularly benzene and TNF-α in single pollutant models. No consistent patterns were found for psychosocial factors in single-exposure linear regression models. In joint effects analyses, the SOM profile with high indoor air pollution, low SES, and high maternal depressive symptoms were associated with higher inflammation. Indoor air pollutants were consistently associated with increased inflammation in both individual and joint effects models, particularly in combination with low SES and maternal depressive symptoms. The trend for individual psychosocial factors was not as clear, with mainly null associations. As we have observed pro- and anti-inflammatory effects, future research should investigate joint effects of these exposures on inflammation and their health effects.

Threat versus deprivation in mother's childhood: Differential relations to hair cortisol and psychopathology in pregnancy

BackgroundThe negative effects of childhood maltreatment can be intergenerational, and the prenatal period may play an important role in this intergenerational transmission. Maternal hypothalamic-pituitary-adrenal (HPA) axis dysfunction and maternal psychopathology represent two mechanisms through which the effects of childhood maltreatment are hypothesized to be transmitted across generations. ObjectiveThis study first sought to extend prior research on pathways of intergenerational transmission by examining whether mothers' childhood experiences of abuse versus neglect differentially relate to maternal HPA activity and to maternal psychopathology during the prenatal period. Second, exploratory analyses examined the links between maternal variables and their State Protective Service involvement as a parent, as an indicator of maladaptive caregiving. MethodsDuring the third trimester of pregnancy, 51 women reported on experiences of childhood maltreatment, on State Protective Service involvement as an adult parent, and on current depressive and post-traumatic stress symptoms, and provided a hair sample for cortisol assay. ResultsRegression analyses indicated that greater severity of abuse, but not neglect, in childhood was associated with higher maternal depressive symptoms (β = 0.488, p = .020). In contrast, greater severity of neglect, but not abuse, in mothers' childhood was associated with lower maternal hair cortisol concentration (β = −0.437, p = .031). Lower maternal hair cortisol concentration, but not maternal psychopathology or severity of childhood abuse or neglect, in turn, was associated with State Protective Service involvement (β = −0.785, p < .001). ConclusionsFindings extend prior work by suggesting that childhood abuse and neglect may have different sequelae for mothers during pregnancy and that these sequelae may have different relations to parenting.

Development of Infant High-Intensity Fear and Fear Regulation from 6 to 24 Months: Maternal Sensitivity and Depressive Symptoms as Moderators.

This study tested bidirectional relations between infant high-intensity fear and fear regulation over 1.5years, and maternal sensitivity and depressive symptoms as moderators. Participants were 1,292 mother-infant pairs prospectively assessed at three times when infants were 6, 15, and 24months old. Infant high-intensity fear and fear regulation (avoidance, orienting to mother, attention regulation, and self-soothing) were observed during the Mask Task at each of these time points. Likewise, mothers reported their depressive symptoms, and their sensitivity was observed in a separate mother-child interaction task at each time point. Conditional multilevel growth models revealed that highly avoidant infants exhibited less initial high-intensity fear, but faster growth in high-intensity fear over time. Furthermore, highly avoidant infants exhibited more concurrent high-intensity fear when their mothers demonstrated low sensitivity. Unexpectedly, when their mothers were highly depressed, infants who used more attention regulation demonstrated more rapid growth of high-intensity fear over time. Finally, when their mothers were not depressed, infants exhibiting more high-intensity fear oriented more to their mothers concurrently. When their mothers reported high depressive symptoms over time, infants with more high-intensity fear initially oriented less to their mothers but more rapidly increased orienting to their mothers over time. Findings reveal the interplay between infant and maternal factors over time in development of infant high-intensity fear. In particular, maternal sensitivity protected highly fearful infants by rapidly reducing fear reactivity despite infant avoidance. In contrast, high maternal depressive symptoms introduced both immediate and enduring risks for infant fear development. Clinical implications are discussed.

Maternal depressive symptoms and language development: The moderating role of child temperament.

The current study examined the interaction between maternal depressive symptoms and child temperament in predicting subsequent child language skills. Participants were 252 mother-child dyads recruited from the All Our Families longitudinal cohort, a primarily middle-class sample (62.9% completed postsecondary education) from Alberta, Canada (90.5% White, 6% Asian, 3.5% other). Maternal depressive symptoms at age 3, controlling for prenatal depressive symptoms, did not evidence a direct effect on child language skills at age 5 (49.6% males; mean [M] = 5.12 years old, standard deviation [SD] = .11). However, both child surgency and effortful control interacted with maternal depression at age 3 to predict later language skills. Low effortful control was a risk factor for poorer language abilities in contexts of high maternal depressive symptoms. High child surgency emerged as a differential susceptibility marker, predicting poorer language skills in contexts of high maternal depressive symptoms but better language skills in contexts of low depressive symptoms. Negative affect did not interact with maternal depressive symptoms in predicting language skills. These findings highlight the complex interaction between maternal and child characteristics in predicting language development during a developmental period in which language skills are a prime indicator of school readiness and a predictor of future academic achievement and socioemotional adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Moderators of Psychosocial Intervention Response for Children and Adolescents with Conduct Problems

ABSTRACT Objective: The purpose of this Brief Report is to synthesize the current evidence base examining moderators of psychosocial intervention response for children and adolescents with conduct problems (CP). We also provide directions for future research. Method: We focused on four categories of psychosocial interventions for the prevention and/or treatment of CP: (1) parent management training (PMT) for children, (2) other family-based interventions for adolescents, (3) youth skills training, and (4) multicomponent interventions (i.e., family-based intervention plus skills training). Emphasis is placed on findings from meta-analyses. Results: Moderation analyses have occurred more frequently for PMT than for other types of interventions. Variables for which there was consistent evidence for positive moderation included higher initial severity of CP, father engagement, higher maternal depressive symptoms, individual administration (vs. group), and treatment/targeted prevention approaches (vs. universal prevention). Variables where there was evidence for no moderation (demonstrating generalizability) included child diagnostic status and family risk in PMT, and diagnostic status and intervention setting for skills training. However, for some variables, evidence of moderation was dependent on intervention type. Conclusions: Future research should examine multiple moderators in combination; incorporate innovative techniques such as integrative data analyses, individual participant data, and class-based modeling, which may identify moderator effects that are undetected by more traditional variable-oriented moderation analyses; and conduct moderated mediation models for informing developmental theory on the interplay of risk and protective factors.

Associations between maternal depressive symptoms and child internalizing problems

ABSTRACT This longitudinal study examined the moderating roles of language use and gender in the relations between maternal depressive symptoms and child internalizing behaviour problems in 242 preschool children (48% girls) enrolled in Head Start centres. Teachers and parents completed the Child Behavior Checklist for Ages 1½-5. Mothers completed the Center for Epidemiological Studies Depression Scale. Results indicated the concurrent and longitudinal relationships between maternal depressive symptoms and child internalizing problems (as reported by mothers but not teachers) varied by language use, such that higher maternal depressive symptoms predicted internalizing problems for children who spoke Spanish as primary language, but not for English-speaking children. Gender did not play a role in the association between maternal depressive symptoms and internalizing problems. The importance of supporting Spanish-speaking children and families was discussed.

Chronic Maternal Depressive Symptoms Are Associated With Reduced Socio-Emotional Development in Children at 2 Years of Age: Analysis of Data From an Intervention Cohort in Rural Pakistan.

Background: Maternal depression affects a high proportion of women during the antenatal and postnatal period in low- and middle-income countries. While maternal depression is recognized as a significant risk for poor early child development that warrants interventions, the effects of chronic maternal depression on children’s development are less understood. Objective: To determine the association of chronicity of maternal depressive symptoms and early child development in a rural population in southern Pakistan. Materials and Methods: This study employs data from the “Pakistan Early Child Development Scale-Up Trial,” a randomized controlled study that evaluated the integration of responsive stimulation and nutrition interventions in a community health service. In the present analysis, linear regression was used to test the effects of chronicity of high maternal depressive symptoms on children’s early development (n = 1205 mother-infant dyads). Children’s development was assessed using the Bayley Scales of Infant and Toddler Development at 24 months of age. Maternal depressive symptoms were assessed at baseline and every 6 months using the Self-Reporting Questionnaire. Results: No significant associations were observed between chronic maternal depressive symptoms and child cognitive, language, or motor development after adjusting for parental characteristics, the caregiving environment and socioeconomic variables. A negative significant association between chronicity of high maternal depressive symptoms and child socio-emotional development (β coefficient −2.57, 95% CI: −5.14; −0.04) was observed after adjusting for the selected variables. Conclusions: The results suggest that interventions designed to promote early child development should also integrate repeat screening for depression and longer-term psychosocial support for mothers.

Mechanisms underlying exposure to partner violence and children's emotional-behavioral difficulties.

Intimate partner violence (IPV) between parents can have a serious impact on children's health, well-being, and development. This study aimed to investigate the longitudinal associations between exposure to IPV in the first year postpartum and children's emotional-behavioral well-being at age 10 years, where maternal depressive symptoms and involvement in home learning activities at 4 years mediate this relationship. A second aim was to test for the moderating effects of child gender and economic disadvantage. Data were drawn from 1,385 Australian mothers and children participating in the Maternal Health Study; a prospective longitudinal study of women's health after childbirth. Results revealed that IPV in the first year postpartum was associated with higher maternal depressive symptoms at 4 years postpartum, which was, in turn, associated with children's emotional-behavioral difficulties at age 10 years. These associations remained significant after adjusting for concurrent exposure to IPV and maternal depressive symptoms at 10 years. There was no evidence of moderation by child gender, but there was for economic disadvantage. The associations between early life exposure to IPV, maternal depressive symptoms, and children's emotional-behavioral difficulties were stronger for families experiencing economic disadvantage, while the associations between IPV, maternal involvement, and children's emotional-behavioral difficulties were stronger for those not experiencing disadvantage. These findings can inform prevention and early intervention practices and policies aimed at providing adequate mental health support to women experiencing IPV to minimize the negative impact on children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trajectories of internalizing and externalizing problems in preschoolers of depressed mothers: Examining gender differences

BackgroundThis study sought to examine the development of global and co-occurring internalizing and externalizing problems in preschoolers whose mothers have high depressive symptoms, a topic that is less often studied. MethodThis longitudinal study consisted of 201 families with mothers who reported clinically-relevant depressive symptoms. Mothers rated their depressive symptoms across children's first two years. Children's internalizing and externalizing problems were reported by caregivers or teachers at three waves in early childhood. ResultsUsing growth curve analyses, findings revealed gender-variant patterns in the development of internalizing and externalizing problems. Across early childhood, boys of mothers with depressive symptoms exhibited stable internalizing and increasing externalizing problems whereas girls exhibited declining trajectories of both problems. Further examination of within-gender variation indicated the heterogeneity in trajectories of internalizing and externalizing problems only among girls. Moreover, the co-occurrence of internalizing and externalizing problems was evident in both genders. LimitationsThis study was based on a community sample and thus caution should be exerted to generalize findings to clinical samples. ConclusionsFindings suggest that boys may be at heightened risk for behavioral problems in the face of high maternal depressive symptoms and that internalizing and externalizing problems tend to co-occur in this group of at-risk preschoolers.

Infant Vagal Tone and Maternal Depressive Symptoms: A Bottom-Up Perspective

Children vary in their susceptibility to environmental exposures such as maternal depression, but little is known about how children shape those same environments. When raising an infant with low arousal, mothers at risk of depression may experience decreased parenting self-efficacy and increased depressive symptoms. We evaluated a longitudinal mediated moderation model that hypothesized interactive effects of infant vagal tone (indexed by respiratory sinus arrhythmia [RSA]) and maternal postpartum depressive (PPD) symptoms on maternal depressive symptoms in early childhood via parenting self-efficacy. Among a sample of 322 very low-income Mexican American mother–infant dyads (46% male infants), infant RSA was assessed at 6 weeks of age; mothers (M age = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 weeks to 6 months, parenting self-efficacy at 18 and 24 months, and depressive symptoms at 18 and 36 months. Higher PPD symptoms predicted higher maternal depressive symptoms at 36 months, especially among mothers whose infants had lower resting RSA. The interactive effect of PPD symptoms and infant RSA on 36-month depressive symptoms was partially mediated by lower parenting self-efficacy. Lower infant RSA may exacerbate the detrimental effects of PPD symptoms on subsequent maternal well-being via damage to mothers’ beliefs in their ability to parent effectively.

Long-term Influences of Prenatal Maternal Depressive Symptoms on the Amygdala–Prefrontal Circuitry of the Offspring From Birth to Early Childhood

BackgroundPrenatal maternal depression may have long-term impacts on amygdala-cortical development. This study explored associations of prenatal maternal depressive symptoms on the amygdala-cortical structural covariance of the offspring from birth to early childhood, derived from a longitudinal birth cohort. MethodsStructural magnetic resonance imaging was performed to obtain the amygdala volume and cortical thickness at each time point. Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale at 26 weeks of pregnancy. Regression analysis was used to examine the effects of the Edinburgh Postnatal Depression Scale on a structural coupling between the amygdala volume and cortical thickness at birth (n = 167) and 4.5 years of age (n = 199). ResultsGirls whose mothers had high prenatal maternal depressive symptoms showed a positive coupling between the amygdala volume and insula thickness at birth (β = .617, p = .001) but showed a negative coupling between the amygdala volume and inferior frontal thickness at 4.5 years of age (β = −.369, p = .008). No findings were revealed in boys at any time point. ConclusionsThe development of the amygdala–prefrontal circuitry is vulnerable to environmental factors related to depression. Such a vulnerability might be sex dependent.

Associations of Prenatal and Postnatal Maternal Depressive Symptoms with Offspring Cognition and Behavior in Mid-Childhood: A Prospective Cohort Study.

Exposure to maternal depressive symptoms in the peri-pregnancy periods may be associated with poorer child development, but research is often limited to only maternal assessments of behavior and cognition. This study investigates the specific periods of prenatal and postnatal exposure to maternal depressive symptoms in association with child development using reports from teachers and mothers. This study is based on 1225 mother–child pairs from Project Viva, a prospective pre-birth cohort study. Mothers reported depressive symptoms on the Edinburgh Postpartum Depression Scale (EPDS) in mid-pregnancy as well as at 6 months and 12 months postpartum. Teachers and mothers reported child executive functions using the Behavioral Rating Inventory of Executive Function (BRIEF) and behavior using the Strengths and Difficulties Questionnaire (SDQ). Children completed the Kaufman Brief Intelligence Test (KBIT-2), the Wide Range Assessment of Visual Motor Abilities (WRAVMA), and the Visual Memory Index of the Wide Range Assessment of Memory and Learning (WRAML). We used multivariable linear regression models to examine associations of prenatal and postpartum depressive symptoms with outcomes. Many of the crude associations observed were attenuated after adjusting for demographic factors and maternal IQ, yet some remained significant. For example, high prenatal maternal depressive symptoms were associated with poorer scores on the BRIEF Behavior Regulation Index and some SDQ scales based on reports from teachers and mothers. High prenatal maternal depressive symptoms were associated with poorer behavioral development. Postpartum symptoms did not show strong associations with outcomes once we adjusted for the prenatal period.

Learning helplessness in the family: Maternal agency and the intergenerational transmission of depressive symptoms.

Children of mothers with elevated depressive symptoms may observe and learn a maladaptive cognitive style, including low perceptions of agency, that is, low perceived control over their emotions and circumstances. In turn, children may face increased cognitive vulnerability to depressive symptoms; however, this mediational model has yet to be tested. Using a longitudinal design and testing our hypotheses within a community sample, we investigated the mediating role of maternal agency in the associations between maternal depressive symptoms and child behavioral helplessness and depressive symptoms one and a half years later (M = 18.58 months, SD = 6.91 months). A diverse sample of school-age children (N = 137, 57.4% female, Mage = 9.74 years, SDage = 1.51 years) and their mothers (N = 122) reported on their depressive symptoms at Time 1. A subsample of children and mothers returned to report on depressive symptoms at Time 2 (N = 68 dyads; 49 with complete data prior to multiple imputation). Maternal agency was coded from narrative responses to the Parent Development Interview-Revised for Parents of School-aged Children (Slade et al., 2009), completed at Time 1. Child behavioral helplessness was indicated by low strategy use at the end of a challenging puzzle task at Time 2. Results revealed that lower maternal agency predicted higher child depressive symptoms at Time 2 and mediated the associations between higher maternal depressive symptoms at Time 1 and higher child behavioral helplessness and depressive symptoms at Time 2. Implications for clinical intervention and future investigations are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Prenatal Maternal Depression and Genes in Relation with Amygdala-Cortical Circuits from Birth to Childhood

Background: Prenatal maternal depression and genetic risks for depression may have long-term impacts on amygdala-cortical development. This study explored influences of genetic and prenatal maternal depression risk factors on the amygdala-cortical structural covariance in a relatively large sample at birth (n=180), 4.5 (n=225) and 6 (n=256) years of age. Methods: Structural magnetic resonance imaging was performed to obtain the amygdala volume and cortical thickness at each time point and to assess structural covariance of amygdala-cortical circuits. Prenatal maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Genetic risk was quantified using a polygenic risk score for major depressive disorder (PRSMDD). Regression analysis was used to examine effects of EPDS and PRSMDD on structural coupling between the amygdala volume and cortical thickness at each time point. Findings: Girls with high PRSMDD showed negative coupling between the amygdala volume and inferior temporal/fusiform thickness at both 4.5 (β=- 0.303, p= 0.028) and 6 years of age (β=-0.372, p=0.004) and negative coupling between the amygdala volume and middle frontal thickness only at 6 years of age (β=-0.315, p=0.019). On the other hand, girls with high prenatal maternal depressive symptoms showed positive coupling between the amygdala volume and insula thickness at birth (β=0.617, p=0.001) but negative coupling between amygdala volume and inferior frontal thickness at age of 4.5 years (β=-0.369, p=0.008). No findings were found in boys at any time point. Interpretation: The vulnerability of the development of the amygdala-cortical circuitry to environmental and genetic risk factors related to depression might be sex-dependent. Funding Statement: This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), SingaporeNMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore Ministry of Education (Academic research fund tier 1; NUHSRO/2017/052/T1-SRP-Partnership/01), and NUS Institute of Data Science, Singapore. Declaration of Interests: No author has conflict of interest. Ethics Approval Statement: The prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) longitudinal birth cohort study was approved by the National Healthcare Group Domain Specific Review Board (NHG DSRB) and the Sing Health Centralized Institutional Review Board (CIRB). Written informed consent was obtained from mothers.

Maternal prenatal depression predicts infant negative affect via maternal inflammatory cytokine levels

Maternal depressive symptoms during pregnancy are associated with risk for offspring emotional and behavioral problems, but the mechanisms by which this association occurs are not known. Infant elevated negative affect (increased crying, irritability, fearfulness, etc.) is a key risk factor for future psychopathology, so understanding its determinants has prevention and early intervention potential. An understudied yet promising hypothesis is that maternal mood affects infant mood via maternal prenatal inflammatory mechanisms, but this has not been prospectively examined in humans. Using data from a pilot study of women followed from the second trimester of pregnancy through six months postpartum (N = 68) our goal was to initiate a prospective study as to whether maternal inflammatory cytokines mediate the association between maternal depressive symptoms and infant offspring negative affect. The study sample was designed to examine a broad range of likely self-regulation and mood-regulation problems in offspring; to that end we over-selected women with a family history or their own history of elevated symptoms of attention-deficit/hyperactivity disorder. Results supported the hypothesis: maternal pro-inflammatory cytokines during the third trimester (indexed using a latent variable that included plasma interleukin-6, tumor necrosis factor-alpha and monocyte chemoattractant protein-1 concentrations as indicators) mediated the effect, such that higher maternal depressive symptoms were associated with higher maternal inflammation, and this mediated the effect on maternal report of infant negative affect (controlling for maternal affect during the infant period). This is the first human study to demonstrate that maternal inflammatory cytokines mediate the association between prenatal depression and infant outcomes, and the first to demonstrate a biological mechanism through which depressive symptoms impact infant temperament.

Maternal characteristics and behavioural/emotional problems in preschoolers: how they relate to sleep rhythmic movements at sleep onset.

Sleep rhythmic movements have been speculated to be a form of self-soothing. While this sleep-related movement has been associated with lower socioeconomic status, psychopathologies and maternal characteristics, prospective studies with sizeable sample and objective measurements are lacking. The objectives were: (a) to identify maternal characteristics predicting sleep rhythmic movements in children; and (b) to document behavioural/emotional problems in preschoolers with sleep rhythmic movements. Participants were mother-child dyads (N=529) from the Adversity: Maternal Adversity, Vulnerability and Neurodevelopment cohort. Questionnaires evaluating socioeconomic status (prenatal), maternal depressive symptoms (prenatal, 48months), sleep rhythmic movements (12, 18, 24, 36, 48months), maternal anxiety trait (24months) and children's behavioural/emotional problems (48months) were used. Maternal sensitivity (accuracy and appropriateness of mother's responses to her baby's needs) was assessed objectively with a filmed mother-infant interaction (6months). Generalized estimating equationwas used to investigate associations between sleep rhythmic movements and maternal characteristics (depression, anxiety and sensitivity). Linear regressions were used to assess associations between sleep rhythmic movements and behavioural/emotional problems in children. Lower maternal sensitivity, higher maternal depressive symptoms and lower socioeconomic status predicted sleep rhythmic movements in children (p<0.05). To our knowledge, this is the first study showing that sleep rhythmic movements are associated with lower maternal sensitivity, measured objectively. This study also builds on previous reports, by documenting an association between sleep rhythmic movements and behavioural/emotional problems even in preschoolers. The presence of psychosocial factors in sleep rhythmic movements aetiology should be considered in treatment.

Placental Morphology Is Associated with Maternal Depressive Symptoms during Pregnancy and Toddler Psychiatric Problems

Maternal depressive symptoms during pregnancy predict increased psychiatric problems in children. The underlying biological mechanisms remain unclear. Hence, we examined whether alterations in the morphology of 88 term placentas were associated with maternal depressive symptoms during pregnancy and psychiatric problems in 1.9–3.1-years old (Mean = 2.1 years) toddlers. Maternal depressive symptoms were rated biweekly during pregnancy with the Center of Epidemiological Studies Depression Scale (n = 86). Toddler psychiatric problems were mother-rated with the Child Behavior Checklist (n = 60). We found that higher maternal depressive symptoms throughout pregnancy [B = −0.24 Standard Deviation (SD) units: 95% Confidence Interval (CI) = −0.46; −0.03: P = 0.03; Mean difference = −0.66 SDs; 95% CI = −0.08; −1.23: P = 0.03; between those with and without clinically relevant depressive symptoms] were associated with lower variability in the placental villous barrier thickness of γ-smooth muscle actin-negative villi. This placental morphological change predicted higher total (B = −0.34 SDs: 95% CI = −0.60; −0.07: P = 0.01) and internalizing (B = −0.32 SDs: 95% CI = −0.56; −0.08: P = 0.01) psychiatric problems in toddlers. To conclude, our findings suggest that both maternal depressive symptoms during pregnancy and toddler psychiatric problems may be associated with lower variability in the villous membrane thickness of peripheral villi in term placentas. This lower heterogeneity may compromise materno-fetal exchange, suggesting a possible role for altered placental morphology in the fetal programming of mental disorders.

Maternal Depressive Symptoms and Child Behavior among Mexican Women and Their Children.

Over 50% of mothers in rural Mexico have high depressive symptoms, and their children’s health and development are likely to be negatively affected. A critical question is whether children vary in their vulnerability to the effects of high maternal depressive symptoms according to their indigenous ethnicity, maternal education, or household wealth. Our sample included 4442 mothers and 5503 children from an evaluation of Mexico’s social welfare program. Maternal depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) Scale, and child behavior was measured using an adapted version of the Behavior Problems Index (BPI). Multiple linear regression models were used to explore the associations between maternal depressive symptoms and child behavior problems, and the heterogeneity of associations by indigenous ethnicity, maternal education, and household assets. We found that having greater maternal depressive symptoms was significantly associated with having a child with more behavior problems (β = 0.114, p < 0.0001, [95% CI 0.101, 0.127]), in adjusted models. In tests of heterogeneity, the association between maternal depressive symptoms and child behavior problems was strongest in households with indigenous ethnicity, low maternal education, or in households with fewer assets. These results strengthen the case for effective mental health interventions in low- and middle-income countries, particularly among the most vulnerable families where mothers and children appear to be at the greatest risk.

Maternal depressive symptoms and adolescent academic attainment: Testing pathways via parenting and self-control

Maternal depression is associated with reduced academic attainment in children, however, it is not clear how this association comes about. Depressive symptoms are associated with impairment in social roles including parenting. Children's self-control is an important contributor to academic attainment and is influenced by parenting. We therefore hypothesised that impaired parenting and children's self-control may mediate links between maternal depression and children's academic attainment. Data were from a brief longitudinal study (3 waves) of UK children aged 11–12 years and their mothers. Higher maternal depressive symptoms at baseline were associated with lower academic attainment in children assessed one year later. There was evidence to support an indirect effect of maternal depressive symptoms on children's academic attainment through the mother-child and the father-child relationship which, in turn, reduced children's self-control. These influences were independent of socio-economic deprivation. A direct effect of maternal depression on children's academic attainment was also observed.