Infants Of Depressed Mothers Research Articles

Cohort profile: the U-BIRTH study on peripartum depression and child development in Sweden

PurposeThe current U-BIRTH cohort (Uppsala Birth Cohort) extends our previous cohort Biology, Affect, Stress, Imaging and Cognition (BASIC), assessing the development of children up to 11 years after birth. The...

Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates

Background: While numerous studies have demonstrated maternal depression’s influence on infant brain development, few studies have examined the changes that occur as a consequence of co-occurring experiential factors that affect quality of mother and infant affectionate touch as well as infant temperament and neurophysiological systems. The aim of the study was to examine the interactive effects of maternal depression and breastfeeding on mother and infant affectionate touch and infant temperament and cortical maturation patterns across early development. Methods: 113 mothers and their infants participated when infants were 1 and 3 months of age. Questionnaires to assess maternal depressive symptoms, feeding, and temperament were completed. Tonic EEG patterns (asymmetry and left and right activity) were collected and the dyads were video-recorded during feeding to assess mother and infant affectionate touch patterns. Results: Data analysis showed that EEG activity and mother-infant affectionate touch differed as a function of mood and feeding method. Notably, only infants of depressed mothers that bottle-fed showed right frontal EEG asymmetry and attenuated change in the left frontal region across 3 months. Breastfeeding positively impacted affectionate touch behaviors and was associated with increased left and decreased right frontal EEG activation even for depressed groups. Furthermore, a model incorporating physiology, maternal depression, touch, temperament, and feeding indicated significant prediction for infant affectionate touch (with breastfeeding and affectively positive temperament demonstrating the strongest prediction). Con­clusion: The findings suggest that breastfeeding and the infant’s positive temperament influence mother-infant affectionate touch patterns and result in neuroprotective outcomes for infants, even those exposed to maternal depression within early development.

Consistency of EEG asymmetry patterns in infants of depressed mothers.

We evaluated frontal electroencephalogram (EEG) asymmetry across multiple contexts as an index of a general affective response predisposition in 12-month-old infants whose mothers were at elevated risk for perinatal depression due to their mother's history of depression. We further examined mothers' prenatal, postnatal, and concurrent depressive symptom levels in relation to infants' frontal EEG asymmetry consistency. Mothers (n=132) with a history of depression prior to pregnancy completed depressive symptom scales repeatedly during pregnancy and the first year postpartum. Their 12-month-old infants' frontal EEG asymmetry was recorded across five contexts (baseline/bubbles, peek-a-boo, play, feeding, and distract). Frontal EEG asymmetries showed small to moderate correlations across contexts. Mothers' prenatal depression symptom levels (not postnatal or concurrent) were associated with infants having consistent right, rather than left, frontal EEG asymmetry, even after controlling for infants' observed affect. These findings demonstrate the consistency of EEG asymmetry scores across contexts in 12-month-old infants at risk for the development of psychopathology, providing support for relative right frontal EEG asymmetry as a trait marker of vulnerability to depression. Findings also suggest the importance of mothers' prenatal, rather than postnatal or concurrent depression, in predicting infants' consistent patterns of relative right frontal EEG asymmetry across contexts.

Examining Pathways Underlying the Association Between Maternal Depressive Symptoms and Infant Weight Outcomes

Abstract Objectives Evidence for an association between maternal depression and child obesity is mixed. We test the association between maternal depressive symptoms (DS) and infant weight-for-age z-scores (WAZ) and three pathways, limited breastfeeding, maternal responsivity, and infant temperament, proposed to underlie this association. Methods Data come from 371 African-American mother-infant pairs participating in the Mothers & Others Study, a home-based intervention to prevent early development of obesity. Data were collected at 28-weeks gestation and 3, 6, 9, 12, and 15 months postpartum. At each postnatal visit, infant weight was directly measured and maternal DS, breastfeeding history, infant feeding styles, and infant temperament were collected using validated instruments. Longitudinal mixed effects models tested the association between maternal DS and infant WAZ. Path analyses tested for mediation by breastfeeding duration, responsive feeding, and infant fussiness. DS were included in final models as a 4-level categorical variable (no symptoms, prenatal only, postnatal only, both pre- and postnatal) to test whether the timing and/or duration of maternal DS were differently associated with WAZ. Results Prevalence of maternal DS ranged from 30.4% prenatally to 13.9% at 15 months. Maternal DS were inversely associated with infant WAZ in adjusted models. A significant time trend was found, with infants of depressed mothers having lower WAZ trajectories. No evidence for mediation through breastfeeding or responsive feeding was found. Maternal DS had a significant indirect effect through perception of infant fussiness (β = 0.02, CI: 0.01, 0.04). Finally, compared to infants of mothers with no depressive symptoms, infants of mothers with both pre- and postnatal symptoms had significantly smaller WAZ from 0–15 months (β = −0.41, P = 0.03). Conclusions Our analysis suggests that maternal DS are associated with lower, not higher, infant WAZ. Maternal perception of infant temperament may be an important underlying pathway, but more research is needed on the mechanisms linking maternal depression to caregiving practices and infant weight gain trajectories. Funding Sources National Institute of Child Health and Human Development.

Postnatal depression and infant growth in an urban area of Bangladesh

Postnatal depression (PND) has been a common depressive mental disorder among the mothers in a low-income country like Bangladesh where stunting, underweight and wasting are prevalent among infants. The present prospective cohort study was carried out among 297 non-depressed and 103 depressed mothers (ages 18–36 years) to find the association between post natal depression and growth of infants. Data were collected by face to face interview through semi-structured questionnaires and anthropometric measurements were taken with proper anthropometric techniques and calibrated instruments. Postnatal depression was assessed by the Edinburgh Postnatal Depression Scale and infants' physical growth was assessed by Z score of weight, length and Mid-Upper Arm Circumference (MUAC). The overall prevalence of post natal depression was found 22% [95% CI, 21.71–30.29]. Infants of depressed mothers were found iller in comparison with the infants of non-depressed mothers (p < 0.001) which could result in growth retardation of infants. According to the MUAC level, infants of depressed mothers were more at risk of malnutrition (p < 0.001). Early detection of postpartum depression, implementation of interventions, prevention or treatment of maternal depressive disorders and effective strategies will not only ameliorate the impact of PND among mothers but also facilitates infant growth.

Perinatal depression effects: A narrative review

This narrative review summarizes publications from the last eight years (2010-2018) on the early interactions, developmental effects and physiological and biochemical profiles of perinatally depressed mothers and their infants. Depressed mothers are nonresponsive with their infants.The depressed mothers’ physiological profiles including low vagal activity, right frontal EEG activation and fMRI activation differences are consistent with the mothers’ lack of responsivity during interactions with their infants. Biomarkers of the mothers that would affect their mood states include elevated cortisol as well as low serotonin, dopamine and oxytocin levels. The infants of depressed mothers come to early interactions with a prenatal history of growth delays and less responsivity to fetal stimulation. At birth they have physiological and biochemical profiles that are similar to those of their mothers. They continue to show these profiles in later development (e.g. depressed vagal activity and elevated cortisol). Although their later behavior problems and cognitive delays have been attributed to the depressed mothers’ lack of responsivity during early interactions, these problems may also relate to their own lingering physiological and biochemical profiles. Keywords: Perinatally depression, Biomarkers

Genome-wide DNA methylation in 1-year-old infants of mothers with major depressive disorder.

A genome-wide methylation study was conducted among a sample of 114 infants (M age = 13.2 months, SD = 1.08) of low-income urban women with (n = 73) and without (n = 41) major depressive disorder. The Illumina HumanMethylation450 BeadChip array with a GenomeStudio Methylation Module and Illumina Custom model were used to conduct differential methylation analyses. Using the 5.0 × 10-7 p value, 2,119 loci were found to be significantly different between infants of depressed and nondepressed mothers. Infants of depressed mothers had greater methylation at low methylation sites (0%-29%) compared to infants of nondepressed mothers. At high levels of methylation (70%-100%), the infants of depressed mothers were predominantly hypomethylated. The mean difference in methylation between the infants of depressed and infants of nondepressed mothers was 5.23%. Disease by biomarker analyses were also conducted using GeneGo MetaCore Software. The results indicated significant cancer-related differences in biomarker networks such as prostatic neoplasms, ovarian and breast neoplasms, and colonic neoplasms. The results of a process networks analysis indicated significant differences in process networks associated with neuronal development and central nervous system functioning, as well as cardiac development between infants of depressed and nondepressed mothers. These findings indicate that early in development, infants of mothers with major depressive disorder evince epigenetic differences relative to infants of well mothers that suggest risk for later adverse health outcomes.

Electroencephalogram patterns in infants of depressed mothers

Electroencephalogram (EEG) patterns may reflect a vulnerability to depression. In an effort to understand their earliest origin, we examined their stability and consistency and their associations with perinatal depressive symptoms. Depressive symptoms were measured prospectively throughout the perinatal period in 83 women with histories of depression and/or anxiety. Infant's EEG was recorded during baseline, feeding, and play at 3 and 6 months of age. Prenatal and postpartum depressive symptoms interacted significantly to predict 3- and 6-month-olds' EEG asymmetry scores. Asymmetry scores were consistent across contexts, except from baseline to feeding and play at 6 months, and stable across ages, except during feeding. Changes in depressive symptoms across ages were not associated with changes in infant EEG. Findings highlight the importance of considering both prenatal and postpartum depressive symptoms in the prediction of infant EEG, as well as the need to consider context to understand stability of infant EEG patterns.

Maternal antenatal depression and infant disorganized attachment at 12 months

Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at three months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at three months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing.

Maternal depression and sex differences shape the infants’ trajectories of cognitive development

The effect of maternal depression on the trajectories of cognitive development was studied in 26 infants with depressed mothers as compared to a group of 24 infants with non-depressed mothers. The infants were tested on Mullen Scales of Early Learning when they were 6, 12 and 18 months old. Mothers reported their depressive symptoms over the follow ups. The study also investigated if there were sex differences in the cognitive trajectories. Multilevel modeling analyses revealed that infants of depressed mothers had a stable lower cognitive score over the period 6–18 months of age as compared to the infants of non-depressed mothers, and that the girls tended to increase their cognitive scores as compared to the boys over the same time period. The results are discussed in light of the stability of depression symptoms over the follow up and sex differences in cognitive development.

Responses to infant-directed singing in infants of mothers with depressive symptoms

This study explored responses to infant-directed (ID) singing in infants of mothers with and without depressive symptoms under two conditions: mother sings to infant, and stranger sings to infant. Sixteen, 3–9-month-old infants of mothers with depression were matched by age and gender to sixteen infants of mothers without depression. Infant gaze responses toward each singer were coded from video and ranged from most negative to most positive, in the order of roaming, averted, neutral, intermittent and sustained. Mothers’ depression status had no effect on infant gaze response toward ID singing from mother or stranger. During ID singing from mother, infants displayed high levels of either neutral or sustained gaze. In response to ID singing from strangers, infants demonstrated sustained gazes more than any other gaze type. Infants also showed significantly more roaming and neutral gaze toward mother than stranger, and used significantly more averted and sustained gaze with stranger than mother. Findings indicate that infants of depressed mothers did not display a depressed interaction style with their mother or with a stranger during ID singing. Additionally, infants in both groups appeared capable of discriminating their mother from a stranger. ID singing appears to enhance face-to-face interaction such that infants can experience self-regulation, even when mothers have depression. Findings support the idea of combining ID singing and interaction coaching as a therapeutic intervention for mothers with depression and their infants.

Atypical development of resting respiratory sinus arrhythmia in children at high risk for depression

Compromised respiratory sinus arrhythmia (RSA, i.e., low cardiac vagal control) frequently characterizes clinically depressed adults and also has been detected in infants of depressed mothers; however, its existence has not been established in older at-risk offspring. We investigated developmental patterns of RSA in a sample of 163 5- to 14-year-old children, who were either at high risk for depression (due to having a parent with a childhood-onset mood disorder) or low-risk for depression. We hypothesized that high-risk children have lower resting RSA than do low-risk children, which could reflect atypical developmental trajectories. Children's RSA was assessed during resting baseline periods on multiple occasions, typically 1-year apart. Linear growth modeling indicated a group by age interaction. Low-risk children (but not the high-risk children) exhibited a significantly increasing trajectory in resting RSA with age. Mood disorders in offspring did not account for the Group X Age interaction effect. Our study provides new evidence that children at high risk for depression have an atypical developmental trajectory of RSA across late childhood.

WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders.

This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide.

An associative learning deficit in 1-year-old infants of depressed mothers: Role of depression duration

The effectiveness of infant-directed speech (IDS) produced by non-depressed mothers for promoting the acquisition of voice-face associations was investigated in 1-year-old children of depressed mothers in a conditioned-attention paradigm. Prior research suggested that infants of mothers with comparatively longer-duration depressive episodes exhibit poorer learning in response to non-depressed mothers’ IDS, but duration of depression was confounded with infant age. In the current study, 1-year-old infants of currently depressed mothers with relatively longer-duration depressive episodes (i.e., perinatal onset) showed significantly poorer learning than 1-year-olds of currently depressed mothers with relatively shorter duration depressive episodes (non-perinatal onset). This was true despite the fact that there were no measurable differences in the severity of depression, level of social functioning, or antidepressant medication use between the two groups. These findings add support to the hypothesis that there is an experience-based change in responsiveness to female IDS in infants of depressed mothers during the first year of life.

Microanalysis of 4-Month Infant Vocal Affect Qualities and Maternal Postpartum Depression

This study examined the association of 6-week maternal self-report depressive symptoms measured by the Center for Epidemiological Studies-Depression Scale (CES-D) with 4-month infant vocal affect qualities. This was part a larger study which examined many additional domains of both infant and maternal behavior. Infant vocal affect qualities were examined in 122 4-month old infants during face-to-face play in relation to 6-week maternal depressive symptoms. Mothers were categorized depressed (26.2%) based on a 16+ cutoff on the CES-D. Videotaped interactions were coded on a 1-s time basis for infant vocal affect qualities (high positive, neutral/positive, fuss/whimper, cry, angry protest and silent.) Infants of depressed mothers were more vocally activated in both positive and negative qualities. In addition, infants of depressed mothers were more vocally variable, specifically in and out of fuss/whimper, as well as more likely to change, rather than maintain vocal states.

Dynamics of emotion regulation in infants of clinically depressed and nondepressed mothers

Emotion regulation (ER) has been conceptualized as an ongoing process of the individual's emotion patterns in relation to moment-to-moment contextual demands. In contrast to traditional approaches of descriptively quantizing ER, we employed a dynamic approach to ER by examining key transitions in infants of clinically depressed and nondepressed mothers in the context of maternal still-face (SF). Mothers with (n = 48) and without a clinical diagnosis of depression (n = 68) were seen in a modified SF paradigm with their 5-month-olds. Infant states and self-soothing behaviors were coded in 1-sec time intervals. Infants of nondepressed mothers used attentional regulatory strategies, whereas infants of depressed mothers used internally directed strategies of self-soothing to reduce negativity and maintain engagement with mother. This study advances our understanding of processes underlying infant ER and points to possible mechanisms for the development of long-term maladaptive ER strategies in infants of depressed mothers.

Right frontal EEG asymmetry and behavioral inhibition in infants of depressed mothers

Recent studies have shown associations between maternal psychopathology and inhibited behaviors in infants. Moreover, physiological factors have been identified as affecting the continuity of behavioral inhibition across childhood. The purpose of the present study was to examine electroencephalogram (EEG) activity and inhibited behavior in 12-month-old infants of depressed versus non-depressed and mothers. Repeated measures MANOVAs indicated that the infants of mothers with stable psychopathology had greater relative right frontal EEG asymmetry, a pattern that typically accompanies greater negative affect and greater withdrawal behaviors. Infants of affectively ill mothers also showed more proximal behaviors toward a stranger and a novel toy than infants of well mothers, but fewer non-proximal behaviors toward their mothers. These results are discussed within a framework of behavioral inhibition for infants exposed to early psychopathologies in their mothers.

Touching behaviors of infants of depressed mothers during normal and perturbed interactions

The present study investigated the touching behaviors of 4-month-old infants of depressed and non-depressed mothers during the still-face (SF; maternal emotional unavailability) and separation (SP; maternal physical unavailability) procedures. Forty-one dyads participated in the present study; dyads were from low SES backgrounds and they exhibited poor relationship qualities (e.g. poor maternal sensitivity, low infant responsiveness); thus, they were considered at-risk. Results indicated that infants exhibited more patting and pulling when mothers were unavailable during the SF and SP procedures. Moreover, depression affected infants’ tactile behaviors: infants of depressed mothers used more reactive types of touch (i.e. active touching behaviors, such as grab, pat, pull) than infants of non-depressed mothers during emotional and physical unavailability, suggesting greater activity levels in infants of depressed mothers. Negative relationship indicators, such as maternal intrusiveness and hostility, predicted soothing/regulatory (i.e. nurturing) and reactive/regulatory types of touch, even after controlling for maternal depression. Taken together, these results underscore the importance of touch for infant communication and regulation during early social interactions.

Responses to animate and inanimate faces by infants of depressed mothers

Forty infants (mean age 5 months) of depressed mothers and non‐depressed mothers were seated in an infant seat and were exposed to four different degrees of animation, including a still‐face Raggedy Ann doll (about two‐feet tall suspended in front of the infant), the same doll in an animated state talking and head‐nodding, an imitative mother and a spontaneously interacting mother (the more animate mother condition). The infants spent more time looking at the doll, but they smiled and laughed more at the mother. The infants of depressed versus non‐depressed mothers showed less laughing and more fussing when their mothers were spontaneously interacting, but showed more laughing and less fussing during the mother imitation condition. Paradoxically, the infants of non‐depressed mothers were negatively affected by the imitation condition, showing less smiling and laughing and more fussing than they had during the spontaneous interactions.

Association between antenatal depression and low birthweight in a developing country.

Rahman A, Bunn J, Lovel H, Creed F. Association between antenatal depression and low birthweight in a developing country.Objective:There is a high prevalence of depression in south Asian women. We aimed to examine the association between antenatal depression and low birthweight (LBW) in infants in a rural community in Rawalpindi, Pakistan.Method:A total of 143 physically healthy mothers with ICD-10 depression in the third trimester of pregnancy and 147 non-depressed mothers of similar gestation were followed from birth. Infant weight was measured and information collected on socioeconomic status, maternal body-mass index and sociodemographic factors.Results:Infants of depressed mothers had lower birthweight (mean 2910 g) than infants of non-depressed mothers (mean 3022 g). The relative risk for LBW (≤2500 g) in infants of depressed mothers was 1.9 (95% CI 1.3–2.9). The association remained significant after adjustment for confounders by multivariate analyses.Conclusion:Low birthweight is a major public health problem in developing countries. Maternal depression during pregnancy predicts LBW. Interventions aimed at maternal depression may help improve infant outcomes.