Testing competing mediators of the association between pre-conception maternal depression and child health-related quality of life: the MatCH study

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Abstract

Maternal depression is a potent risk factor for poor child development across a number of domains but the mechanisms of transmission are poorly understood. This study aimed to test competing mediators of the association between pre-conception maternal depression and child psychosocial functioning. In 2016, mothers in the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health were asked to be part of the Mothers and their Children’s Health study and to complete surveys on the health of their three youngest children under 13 years. The current study includes children aged 0–12 years (N = 5532, M = 6.99 years, SD = 3.22 years) and their mothers (N = 2917). We used the CESD-10 to measure depression and the PedsQL to measure psychosocial functioning, and used multilevel structural equation modeling to test hypotheses. Pre-conception maternal depression was associated with poorer maternal mental health and parenting after birth. The effect of pre-conception maternal depression was mediated by post-birth maternal depression in children aged 0–4 years (unstandardized regression coefficient (B) = − 0.26, 95%CI − 0.38, − 0.13) and children aged 5–12 years (B = − 0.25, 95%CI − 0.34, − 0.16), and by post-birth maternal stress (B = − 0.04, 95%CI − 0.08, − 0.01), and parenting (B = − 0.03, 95%CI − 0.04, − 0.02) in children aged 5–12 years. Post-birth maternal depression was the strongest mediator. Pre-conception is the optimal time for depression intervention. Post-birth interventions should include a focus on reducing depression and improving negative parenting aspects such as hostility and discipline.

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Change history

  • 05 December 2019

    The current sentence is in the discussion (sub-section The role of pre-conception maternal depression) and reads: ���Pre-conception treatment of mental health issues is also associated with substantial savings in health care costs (Chojenta et al., 2018).���

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Acknowledgements

The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health by the University of Queensland and The University of Newcastle. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data.

Funding

MatCH is funded by the National Health and Medical Research Council (NHMRC) project grant (APP1059550). GM is supported by an NHMRC Principal Research Fellowship (APP1121844).

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Correspondence to Katrina M. Moss.

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The authors declare that they have no conflict of interest.

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Ethics approval for this study was obtained from The University of Queensland and The University of Newcastle, and women provided written informed consent for themselves and their children. All procedures performed were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Moss, K.M., Loxton, D., Dobson, A.J. et al. Testing competing mediators of the association between pre-conception maternal depression and child health-related quality of life: the MatCH study. Arch Womens Ment Health 23, 53–62 (2020). https://doi.org/10.1007/s00737-019-0941-7

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Keywords

  • Maternal depression
  • Child health-related quality of life
  • Mediators
  • Parenting