Skip to main content

Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns

Abstract

Introduction

Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health.

Methods

In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01–32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71–40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health.

Results

Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns.

Discussion

Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants’ health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  • Beijers, R., Jansen, J., Riksen-Walraven, M., & de Weerth, C. (2010). Maternal prenatal anxiety and stress predict infant illnesses and health complaints. Pediatrics, 126(2), e401-9. https://doi.org/10.1542/peds.2009-3226.

    Article  PubMed  Google Scholar 

  • Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: systematic review. Obstetrics and Gynecology, 103(4), 698–709. https://doi.org/10.1097/01.AOG.0000116689.75396.5f.

    Article  PubMed  Google Scholar 

  • Bornstein, M. H., Hahn, C., & Haynes, O. M. (2011). Maternal personality, parenting cognitions, and parenting practices. Developmental Psychology, 47(3), 658.

    Article  PubMed  PubMed Central  Google Scholar 

  • Boyle, E. M., Poulsen, G., Field, D. J., Kurinczuk, J. J., Wolke, D., Alfirevic, Z., & Quigley, M. A. (2012). Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study. British Medical Journal (Clinical Research Ed.), 344, e896. https://doi.org/10.1136/bmj.e896.

    Article  Google Scholar 

  • Calkins, K., & Devaskar, S. U. (2011). Fetal origins of adult disease. Current Problems in Pediatric and Adolescent Health Care, 41(6), 158–176.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chung, E. K., McCollum, K. F., Elo, I. T., Lee, H. J., & Culhane, J. F. (2004). Maternal depressive symptoms and infant health practices among low-income women. Pediatrics, 113(6), e523-e529.

    Article  Google Scholar 

  • Chung, M., Raman, G., Chew, P., Magula, N., Trikalinos, T., & Lau, J. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment, 153, 1–186.

    Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry: The Journal of Mental Science, 150, 782–786.

    CAS  Article  Google Scholar 

  • Dominguez, K., Penman-Aguilar, A., Chang, M., Moonesinghe, R., Castellanos, T., Rodriguez-Lainz, A., & Schieber, R. (2015). Vital signs: Leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States—2009–2013. MMWR Morbidity and Mortality Weekly Report, 64(17), 469–478.

    PubMed  PubMed Central  Google Scholar 

  • Dunkel Schetter, C., & Tanner, L. (2012). Anxiety, depression and stress in pregnancy: Implications for mothers, children, research,and practice. Current Opinion in Psychiatry, 25(2), 141–148. https://doi.org/10.1097/YCO.0b013e3283503680.

    Article  PubMed  PubMed Central  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.

    Google Scholar 

  • Fairlie, T. G., Gillman, M. W., & Rich-Edwards, J. (2009). High pregnancy-related anxiety and prenatal depressive symptoms as predictors of intention to breastfeed and breastfeeding initiation. Journal of Womens Health, 18(7), 945–953. https://doi.org/10.1089/jwh.2008.0998.

    Article  Google Scholar 

  • Field, T. (2011). Prenatal depression effects on early development: A review. Infant Behavior and Development, 34(1), 1–14.

    Article  PubMed  Google Scholar 

  • Field, T., Diego, M., Dieter, J., Hernandez-Reif, M., Schanberg, S., Kuhn, C., et al. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior and Development, 27(2), 216–229.

    Article  Google Scholar 

  • Field, T., Hernandez-Reif, M., & Diego, M. (2011). Depressed mothers’newborns are less responsive to animate and inanimate stimuli. Infant and Child Development, 20(1), 94–105. https://doi.org/10.1002/icd.687.

    Article  Google Scholar 

  • Figueiredo, B., Canário, C., & Field, T. (2014). Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression. Psychological Medicine, 44(05), 927–936.

    CAS  Article  PubMed  Google Scholar 

  • Fuentes-Afflick, E., Hessol, N. A., & Pérez-Stable, E. J. (1999). Testing the epidemiologic paradox of low birth weight in Latinos. Archives of Pediatrics & Adolescent Medicine, 153(2), 147–153.

    CAS  Article  Google Scholar 

  • Garcia-Esteve, L., Ascaso, C., Ojuel, J., & Navarro, P. (2003). Validation of the Edinburgh postnatal depression scale (EPDS) in Spanish mothers. Journal of Affective Disorders, 75(1), 71–76.

    Article  PubMed  Google Scholar 

  • Gress-Smith, J. L., Luecken, L. J., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants. Maternal and Child Health Journal, 16(4), 887–893.

    Article  PubMed  Google Scholar 

  • Grote, N. K., Bridge, J. A., Gavin, A. R., Melville, J. L., Iyengar, S., & Katon, W. J. (2010). A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Archives of General Psychiatry, 67(10), 1012–1024.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hack, M., Klein, N. K., & Taylor, H. G. (1995). Long-term developmental outcomes of low birth weight infants. The Future of Children, 5, 176–196.

    CAS  Article  PubMed  Google Scholar 

  • Kajantie, E. (2006). Fetal origins of stress-related adult disease Stress, obesity, and metabolic syndrome (pp. 11–27). New York: New York Academy of Sciences.

    Google Scholar 

  • Kingston, D., Tough, S., & Whitfield, H. (2012). Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry & Human Development, 43(5), 683–714.

    Article  Google Scholar 

  • Lara, M. A., Le, H., Letechipia, G., & Hochhausen, L. (2009). Prenatal depression in Latinas in the US and Mexico. Maternal and Child Health Journal, 13(4), 567–576.

    Article  PubMed  Google Scholar 

  • Lazinski, M. J., Shea, A. K., & Steiner, M. (2008). Effects of maternal prenatal stress on offspring development: A commentary. Archives of Womens Mental Health, 11(5–6), 363–375.

    Article  Google Scholar 

  • Lindgren, K. (2001). Relationships among maternal–fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24(3), 203–217.

    CAS  Article  Google Scholar 

  • Mac Bird, T., Bronstein, J. M., Hall, R. W., Lowery, C. L., Nugent, R., & Mays, G. P. (2010). Late preterm infants: Birth outcomes and health care utilization in the first year. Pediatrics, 126(2), e311-e319.

    Google Scholar 

  • Midodzi, W. K., Rowe, B. H., Majaesic, C. M., Saunders, L. D., & Senthilselvan, A. (2010). Early life factors associated with incidence of physician-diagnosed asthma in preschool children: Results from the Canadian Early Childhood Development cohort study. Journal of Asthma, 47(1), 7–13.

    Article  PubMed  Google Scholar 

  • NIH Health Disparities Strategic Plan. NIH health disparities strategic plan and budget, fiscal years 20092013 (extended to FY2016).

  • Rahman, A., Iqbal, Z., Bunn, J., Lovel, H., & Harrington, R. (2004). Impact of maternal depression on infant nutritional status and illness: A cohort study. Archives of General Psychiatry, 61(9), 946–952.

    Article  PubMed  Google Scholar 

  • Reiter, J. P., & Raghunathan, T. E. (2007). The multiple adaptations of multiple imputation. Journal of the American Statistical Association, 102(480), 1462–1471.

    CAS  Article  Google Scholar 

  • Rossiter, M. D., Colapinto, C. K., Khan, M. K., McIsaac, J. L. D., Williams, P. L., Kirk, S. F., & Veugelers, P. J. (2015). Breast, formula and combination feeding in relation to childhood obesity in Nova Scotia, Canada. Maternal and Child Health Journal, 19(9), 2048–2056.

    Article  PubMed  Google Scholar 

  • Seckl, J. R. (2001). Glucocorticoid programming of the fetus; adult phenotypes and molecular mechanisms. Molecular and Cellular Endocrinology, 185(1), 61–71.

    CAS  Article  PubMed  Google Scholar 

  • Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., et al. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800–1819.

    Article  Google Scholar 

  • Stewart, R. C. (2007). Maternal depression and infant growth—A review of recent evidence. Maternal & Child Nutrition, 3(2), 94–107.

    Article  Google Scholar 

  • Wambach, K., Domian, E. W., Page-Goertz, S., Wurtz, H., & Hoffman, K. (2016). Exclusive breastfeeding experiences among Mexican American women. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 32(1), 103–111. https://doi.org/10.1177/0890334415599400.

    Article  Google Scholar 

  • Ystrom, E. (2012). Breastfeeding cessation and symptoms of anxiety and depression: A longitudinal cohort study. BMC Pregnancy and Childbirth, 12, 36–36.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study is supported by a Grant, R01 NIMH MH083173 (MPIs: Keith Crnic, Nancy Gonzales and Linda Luecken). The first author of this manuscript was supported by an institutional training Grant, T32 MH18387, NIMH. We thank the mothers and infants for their participation; Kirsten Letham, Anne Mauricio, Monica Gutierrez, and Craig Enders, for their assistance with data collection and management; Dr. Dean Coonrod and the Maricopa Integrated Health Systems for their assistance with recruitment; Kim Battista for graphical design assistance; and the interviewers for their commitment and dedication to this project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. S. Coburn.

Ethics declarations

Conflict of interest

The authors of this manuscript have no conflicts of interests, including financial interests or gains.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Coburn, S.S., Luecken, L.J., Rystad, I.A. et al. Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns. Matern Child Health J 22, 786–793 (2018). https://doi.org/10.1007/s10995-018-2448-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-018-2448-7

Keywords

  • Prenatal depression
  • Mother
  • Infant
  • Health