Children of Prenatally Depressed Mothers: Externalizing and Internalizing Symptoms are Accompanied by Reductions in Specific Social-Emotional Competencies
- 437 Downloads
Studies have shown that child development is negatively affected by prenatal depression. A dysregulated hypothalamic-pituitary-adrenal axis in the pregnant woman, passed to the fetus, is one discussed key mechanism. Studies, investigating primary-school age children, have found effects on antisocial behavior. Effects on internalizing symptoms were not found, but the analysis did not distinguish between anxiety and depression symptoms. Additionally, until now, no objective test data operationalizing social-emotional competencies have been included. The present study examined: 1.Whether the effects on child externalizing symptoms could be replicated; 2. If there are specific effects on child internalizing symptoms, separated for anxiety and depression; and 3. Are child clinical symptoms reflected in reductions in social-emotional competencies. A sample of 61 prenatally depressed and 143 prenatally not-depressed women and their 6–9 year old children were compared, controlling for key confounders in both the perinatal period and in middle childhood. Children of prenatally depressed mothers had more antisocial behavior and depression symptoms reported by their mothers. The prediction of antisocial behavior scores tended to be more significant for boys than for girls. Child anxiety symptoms were primarily explained by current maternal depressive symptoms. Children of prenatally depressed mothers also showed a reduction in social-emotional competencies, specifically regarding the ability to interpret complex social situations. This study showed that, even in a non-clinical sample, there are distinct effects of prenatal depression on child externalizing and internalizing symptoms which are accompanied by reductions in specific social-emotional competencies. These results emphasize that treatment for depressed pregnant women and/or early support for affected families is worthwhile. Additional work is required to identify the underlying biological mechanisms.
KeywordsPrenatal exposure Prenatal depression Child development Conduct disorder Social emotional competence
A.E.: Designed and conducted the FRANCES study, supervised the data acquisition, analyzed the data, interpreted the findings and wrote the paper. L.W.: Contributed to the FRANCES data acquisition, analyzed the data, interpreted the findings and wrote the first draft of the paper. J. Gru: Contributed to the FRANCES design and data acquisition. J. Gri: Contributed to the FRANCES design and data acquisition. J.v.D.: Interpreted the findings, collaborated in the writing and editing of the final manuscript. E.R.: Contributed to the FRANCES design and recruitment. T.W.G.: Initiated, designed and conducted the FRAMES study. P.A.F.: Initiated, designed and conducted the FRAMES study. M.W.B.: Initiated, designed and conducted the FRAMES study. J.K.: Initiated, designed and conducted the FRAMES study. O.K.: Initiated and designed the FRANCES study. H.H.: Initiated, designed and conducted the FRANCES study, interpreted the findings, collaborated in the writing of the manuscript. G.H.M.: Initiated and designed the FRANCES study. All authors corrected the manuscript, provided substantial intellectual input, and approved the final version of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Anna Eichler was supported by the ELAN Fund of the Friedrich-Alexander-University Erlangen-Nuremberg. The remaining authors declare that they have no competing interests.
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
- Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18. Burlington, VT: University of Vermont.Google Scholar
- Baibazarova, E., van de Beek, C., Cohen-Kettenis, P. T., Buitelaar, J., Shelton, K. H., & van Goozen, S. H. (2013). Influence of prenatal maternal stress, maternal plasma cortisol and cortisol in the amniotic fluid on birth outcomes and child temperament at 3 months. Psychoneuroendocrinology, 38(6), 907–915. doi: 10.1016/j.psyneuen.2012.09.015.CrossRefPubMedGoogle Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.Google Scholar
- Döpfner, M., Görtz-Dorten, A., Lehmkuhl, G., Breuer, D., & Goletz, H. (2008). Diagnostik-System für psychische Störungen nach ICD-10 und DSM-IV für Kinder und Jugendliche. Bern: Huber.Google Scholar
- Eichler, A., Grunitz, J., Grimm, J., Walz, L., Raabe, E., Goecke, T. W., et al. (2016). Did you drink alcohol during pregnancy? Inaccuracy and discontinuity of women’s self-reports: On the way to establish meconium ethyl glucuronide (EtG) as a biomarker for alcohol consumption during pregnancy. Alcohol, 54, 39–44. doi: 10.1016/j.alcohol.2016.07.002.CrossRefPubMedGoogle Scholar
- Gentile, S. (2015). Untreated depression during pregnancy: Short- and long-term effects in offspring. A systematic review. Neuroscience. doi: 10.1016/j.neuroscience.2015.09.001.
- Goecke, T. W., Burger, P., Fasching, P. A., Bakdash, A., Engel, A., Haberle, L., et al. (2014). Meconium indicators of maternal alcohol abuse during pregnancy and association with patient characteristics. BioMed Research International, 2014, 702848 doi: 10.1155/2014/702848.CrossRefPubMedPubMedCentralGoogle Scholar
- Grob, A., Meyer, C., & Hagmann-von Arx, P. (2009). Intelligence and development scales (IDS). Bern: Huber.Google Scholar
- Hatzinger, M., Brand, S., Perren, S., von Wyl, A., von Klitzing, K., & Holsboer-Trachsler, E. (2007). Hypothalamic-pituitary-adrenocortical (HPA) activity in kindergarten children: Importance of gender and associations with behavioral/emotional difficulties. Journal of Psychiatric Research, 41(10), 861–870. doi: 10.1016/j.jpsychires.2006.07.012.CrossRefPubMedGoogle Scholar
- Hein, A., Rauh, C., Engel, A., Haberle, L., Dammer, U., Voigt, F., et al. (2014). Socioeconomic status and depression during and after pregnancy in the Franconian Maternal Health Evaluation Studies (FRAMES). Archives of Gynecology and Obstetrics, 289(4), 755–763. doi: 10.1007/s00404-013-3046-y.CrossRefPubMedGoogle Scholar
- Luoma, I., Tamminen, T., Kaukonen, P., Laippala, P., Puura, K., Salmelin, R., & Almqvist, F. (2001). Longitudinal study of maternal depressive symptoms and child well-being. Journal of the American Academy of Child & Adolescent Psychiatry, 40(12), 1367–1374. doi: 10.1097/00004583-200112000-00006.CrossRefGoogle Scholar
- Mehta, D., Quast, C., Fasching, P. A., Seifert, A., Voigt, F., Beckmann, M. W., et al. (2012). The 5-HTTLPR polymorphism modulates the influence on environmental stressors on peripartum depression symptoms. Journal of Affective Disorders, 136(3), 1192–1197. doi: 10.1016/j.jad.2011.11.042.CrossRefPubMedGoogle Scholar
- Moffitt, T. E., Harrington, H., Caspi, A., Kim-Cohen, J., Goldberg, D., Gregory, A. M., & Poulton, R. (2007). Depression and generalized anxiety disorder: Cumulative and sequential comorbidity in a birth cohort followed prospectively to age 32 years. Archives of General Psychiatry, 64(6), 651–660. doi: 10.1001/archpsyc.64.6.651.CrossRefPubMedGoogle Scholar
- Pearson, R. M., Evans, J., Kounali, D., Lewis, G., Heron, J., Ramchandani, P. G., et al. (2013). Maternal depression during pregnancy and the postnatal period: Risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiatry, 70(12), 1312–1319. doi: 10.1001/jamapsychiatry.2013.2163.CrossRefPubMedPubMedCentralGoogle Scholar
- Ravens-Sieberer, U., Wille, N., Erhart, M., Bettge, S., Wittchen, H. U., Rothenberger, A., et al. (2008). Prevalence of mental health problems among children and adolescents in Germany: Results of the BELLA study within the National Health Interview and Examination survey. European Child & Adolescent Psychiatry, 17(Suppl 1), 22–33. doi: 10.1007/s00787-008-1003-2.CrossRefGoogle Scholar
- Rice, F., Harold, G. T., Boivin, J., Hay, D. F., van den Bree, M., & Thapar, A. (2009). Disentangling prenatal and inherited influences in humans with an experimental design. Proceedings of the National Academy of Sciences of the United States of America, 106(7), 2464–2467. doi: 10.1073/pnas.0808798106.CrossRefPubMedPubMedCentralGoogle Scholar
- Rice, F., Harold, G. T., Boivin, J., van den Bree, M., Hay, D. F., & Thapar, A. (2010). The links between prenatal stress and offspring development and psychopathology: Disentangling environmental and inherited influences. Psychological Medicine, 40(2), 335–345. doi: 10.1017/s0033291709005911.CrossRefPubMedGoogle Scholar
- Ruttle, P. L., Shirtcliff, E. A., Serbin, L. A., Fisher, D. B., Stack, D. M., & Schwartzman, A. E. (2011). Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: Longitudinal and concurrent associations with cortisol. Hormones and Behavior, 59(1), 123–132. doi: 10.1016/j.yhbeh.2010.10.015.CrossRefPubMedGoogle Scholar
- Schneider, M., Engel, A., Fasching, P. A., Haberle, L., Binder, E. B., Voigt, F., et al. (2014). Genetic variants in the genes of the stress hormone signalling pathway and depressive symptoms during and after pregnancy. BioMed Research International, 2014, 469278 doi: 10.1155/2014/469278.PubMedPubMedCentralGoogle Scholar