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Impact of trajectories of maternal postpartum depression on infants’ socioemotional development

Pediatric Research volume 96, pages 519–524 (2024)Cite this article

Abstract

Background

We assessed (a) the effects of postpartum depression (PPD) trajectories until 6 months postpartum on infants’ socioemotional development (SED) at age 12 months, and (b) the mediating role of maternal self-efficacy (MSE), and the additional effect of postpartum anxiety at age 12 months.

Methods

We used data from POST-UP trial (n = 1843). PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 1, 3, and 6 months. Infants’ SED was assessed at 12 months using the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE). Structural equations were applied to estimate the effect of PPD trajectories on infants’ SED and mediation by MSE. The additional effects of postpartum anxiety were assessed with conditional regression.

Results

Higher levels of PPD over time were associated with a lower SED (coefficient for log-EPDS 3.5, 95% confidence interval 2.8; 4.2, e.g., an increase in the EPDS score from 9 to 13 worsens the ASQ-SE by 1.3 points). About half of this relationship was mediated by MSE. Postpartum anxiety had an independent adverse effect on SED.

Conclusions

PPD and postpartum anxiety have a negative impact on infants’ SED. MSE as a mediator may be a potential target for preventive interventions to alleviate the negative effects of maternal psychopathology on infants’ SED.

Impact

  • The trajectories of postpartum depression (PPD) from 1 month to 6 months were negatively related to infants’ socioemotional development (SED) at age 12 months, underlining the importance of repeated assessment of PPD.

  • Maternal self-efficacy (MSE) mediated the association between PPD and SED, implying MSE could be a potential target for preventive interventions.

  • An additional independent negative effect of postpartum anxiety was identified, implying the assessment of postpartum anxiety also has a surplus value to identify mothers at risk.

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Fig. 1: Trends of the Edinburgh Postnatal Depression Scale trajectories from 1 to 6 months after birth representing the random intercepts and its variance (n = 1843).
Fig. 2: Mediation model demonstrating the associations (B) and their standard errors (SE); “c” is the total effects model, where c is the total effect of postpartum trajectories (log transformed) on infants’ socioemotional development.

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Data availability

Data for the current study is not publicly available. Reasonable requests for data can be made to the principal investigator of the Post-Up trial, Dr. Magda M. Boere-Boonekamp; m.m.boere-boonekamp@utwente.nl.

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Funding

Funding

Funded by the Netherlands Organization for Health Research and Development (grant number 80-82470-98-012).

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Authors and Affiliations

  1. Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713GZ, Groningen, the Netherlands

    Gireesh Kumar Subbiah, Sijmen A. Reijneveld, Josué Almansa & Marlou L. A. de Kroon

  2. Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands

    Catharina A. Hartman

  3. Netherlands School of Public and Occupational Health, P.O. Box 20022, 3503 LA, Utrecht, the Netherlands

    Angarath I. van der Zee-van den Berg

  4. Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands

    Magda M. Boere-Boonekamp

  5. Department of Public Health and Primary Care, Environment and Health, KU Leuven, Kapucijnenvoer 35, P.O. Box 7001, 3000, Leuven, Belgium

    Marlou L. A. de Kroon

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  1. Gireesh Kumar Subbiah
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Contributions

G.K.S. drafted the initial manuscript, carried out the data analyses and revised the manuscript. M.L.A.d.K. conceptualized and supervised the study, supervised the data analyses and reviewed and revised the manuscript. S.A.R. and C.A.H. supervised the study, reviewed and revised the manuscript. J.A. carried out and supervised data analyses, and revised the manuscript. A.I.v.d.Z.-v.d.B. and M.M.B.-B. conceptualized and designed the POST-UP trial, and coordinated and supervised data collection, and critically reviewed the manuscript. All authors have read and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Gireesh Kumar Subbiah.

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Subbiah, G.K., Reijneveld, S.A., Hartman, C.A. et al. Impact of trajectories of maternal postpartum depression on infants’ socioemotional development. Pediatr Res 96, 519–524 (2024). https://doi.org/10.1038/s41390-023-02697-w

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