母体うつ病症状のタイミング、養育行動、および子供の転帰との関連性の検討

Perinatal depression is associated with poor psychosocial functioning, impaired parent-child relationship quality, and confers risk for offspring psychopathology and altered brain structure. In this study, we investigated the relative associations between the timing of perinatal depressive symptoms (prenatal, postnatal, and concurrent) and toddler psychopathology symptoms, toddler brain structure, and parenting behaviors. We then explored whether parenting behaviors mediated relations between perinatal depressive symptoms and child psychopathology outcomes.

We used longitudinal data from 220 pregnant women and singleton offspring in the Early Life Adversity and Biological Embedding Study, examining associations from the first trimester of pregnancy to three years postpartum. Linear mixed effect analyses examined associations between the timing of maternal depressive symptoms and toddler brain and behavioral development. We also investigated whether maternal depressive symptoms were indirectly associated with child psychopathology symptoms through parenting behaviors. Our data included multiple time points of maternal depressive symptoms (prenatal, early postnatal, late postnatal, and concurrent) and child outcomes (psychopathology symptoms and brain structure at ages 2 and 3 years), which allowed us to examine dynamic associations within dyads.

Higher levels of early postnatal maternal depressive symptoms, above and beyond prenatal and concurrent depressive symptoms, were associated with greater toddler externalizing (β=0.15, p=.02, q=.05). Non-supportive parenting behaviors partially mediated these relationships (p=.02) and were directly associated with greater child externalizing symptoms (β=0.14, p=.03).

Findings suggest temporal differences in the relationship of perinatal depressive symptoms to child psychopathology. Specifically, postnatal maternal depressive symptoms were associated with toddler externalizing symptoms. Non-supportive parenting behaviors partially explained these relationships. Results emphasize the importance of early and accessible identification, intervention, and treatment of postnatal depressive symptoms.