Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 8, pp 1335–1345 | Cite as

Antenatal and postnatal maternal mental health as determinants of infant neurodevelopment at 18 months of age in a mother–child cohort (Rhea Study) in Crete, Greece

  • Katerina KoutraEmail author
  • Leda Chatzi
  • Manolis Bagkeris
  • Maria Vassilaki
  • Panos Bitsios
  • Manolis Kogevinas
Original Paper



A growing body of evidence links poor maternal mental health with negative outcomes on early child development. We examined the effect of antenatal and postnatal maternal mental health on infant neurodevelopment at age 18 months in a population-based mother–child cohort (Rhea Study) in Crete, Greece.


Self-reported measures of maternal depression (EPDS), trait anxiety (STAI-Trait) and personality traits (EPQ-R) were assessed in a sample of women during pregnancy and at 8 weeks postpartum (n = 223). An additional sample of 247 mothers also completed the EPDS scale at 8 weeks postpartum (n = 470). Neurodevelopment at 18 months was assessed with the use of Bayley Scales of Infant and Toddler Development (3rd edition).


Multivariable linear regression models adjusted for confounders revealed that antenatal depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive development independently of postnatal depression. High trait anxiety and extraversion were associated with decrease and increase, respectively, in social–emotional development. Also, high trait anxiety and neuroticism had a positive effect on infants’ expressive communication. Finally, postpartum depressive symptoms (EPDS ≥ 13) were associated with decrease in cognitive and fine motor development independently of antenatal depression.


These findings suggest that antenatal and postnatal maternal psychological well-being has important consequences on early child neurodevelopment.


Antenatal maternal mental health Postpartum depression Infant neurodevelopment 



Rhea cohort was supported by European projects (EU FP6-2003-Food-3-A NewGeneris, EU FP6. STREP HiWATE, EU FP7 ENV.2007. Project No 211250 Escape, EU FP7-2008-ENV- EnviroGenoMarkers, EU FP7-HEALTH-2009- single-stage CHICOS, EU FP7 ENV.2008. Proposal No 226285 ENRIECO); and by the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011–2014). We are grateful to all those who participated in the study especially the mothers and their infants, the psychologists who assisted in infants’ neurodevelopmental assessment and the whole Rhea team for their contribution and understanding. We also acknowledge Raquel Garcia Esteban, Barcelona, for conducting the standardisation of Bayley’s scores.

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Katerina Koutra
    • 1
    • 2
    Email author
  • Leda Chatzi
    • 1
  • Manolis Bagkeris
    • 1
  • Maria Vassilaki
    • 1
  • Panos Bitsios
    • 2
  • Manolis Kogevinas
    • 3
    • 4
    • 5
    • 6
  1. 1.Department of Social Medicine, Faculty of MedicineUniversity of CreteHeraklionGreece
  2. 2.Department of Psychiatry and Behavioral Sciences, Faculty of MedicineUniversity of CreteHeraklionGreece
  3. 3.National School of Public HealthAthensGreece
  4. 4.Centre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
  5. 5.Municipal Institute of Medical ResearchBarcelonaSpain
  6. 6.CIBER Epidemiologia y Salud Pública (CIBERESP)GranadaSpain

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