Maternal behavioral health symptom profiles in early family life: complexity and context

Behavioral health problems affect at least 15% of mothers, but few studies have examined how different problems cluster together. Characterizing symptom profiles and their correlates early in the family life cycle can extend existing understanding beyond that provided by studies based on single problems. Mothers in the Fragile Families and Child Wellbeing study, a national birth cohort of racially diverse and mostly unmarried mothers (N = 4205), reported depression, anxiety, and substance dependence symptoms. Latent class analysis (LCA) identified mothers' symptom profiles in their children's third year. We explored associations between symptom profiles and demographics, reproductive health outcomes, functional limitations, and postpartum behavioral health. LCA identified five profiles: (1) Depression only (14.5% of sample), (2) Severe depression and anxiety (5.3%), (3) Anxiety only (2.2%), (4) Depression and substance use (1.4%), and (5) Currently symptom free (76.6%). Depressive symptoms were more moderate when co-occurring with substance dependence and more severe when co-occurring with anxiety. Postpartum depression, postpartum anxiety, and smoking during pregnancy were the most robust correlates of being symptomatic in year 3. Mothers in the "Severe depression and anxiety" group were more likely to be in that profile if they reported functional impairment and/or relationship dissolution. Mothers in the "Depression only" profile were more likely to have higher parity and/or functional impairment. A quarter of mothers of young children had significant behavioral health symptoms, with most reporting depression symptoms. Psychosocial and physical health factors in the pregnancy and postpartum periods were associated with future symptoms, warranting obstetrician and pediatrician attention.