The Biological Mechanism of Maternal Depression’s Negative Influences on Offspring Development: A Review

Maternal depression is a prevalent disorder among mothers: nearly 20% of women have experienced different levels of depressive symptoms during motherhood. The symptoms usually disappear by three years after their children were born, but some women experience them chronically. Maternal depression has been researched in terms of its negative influence on offspring since the 1960s. Children of chronically depressed mothers show delays in cognitive, emotional, and behavioral development. Moreover, they may even face mental health challenges themselves. How does maternal depression influence offspring? Previous studies have focused on the behaviors of mothers and found that mothers with depression interact with their children in a less engaging way. Recently, more researchers started to pay attention to the biological mechanism of this maternal depression’s negative influence. Cortisol, a hormone associated with stress, is regarded as a potential pathway of the transgenerational transmission of depression. Mothers with prenatal depression have elevated cortisol level during pregnancy, which is passed down to their children. After they are born, children of depressed mothers react to stress with more dramatic changes in cortisol level and compromised stress-coping abilities. Moreover, prenatal maternal depression also seems to shape the functional connectivity of amygdala, a brain area related to stress and emotions. For life situations like schooling, competing with peers or making significant decisions, children with decreased or abnormal stress-coping abilities will be in disadvantageous positions. Attenuated stress coping abilities brought by hormonal and neural changes may be a biological mechanism for children’s lower performance in cognitive and behavioral tasks.

The COVID-19 pandemic impacted maternal mental health differently depending on pregnancy status and trimester of gestation

Introduction: We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave.Methods: Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The current analysis includes data on persons enrolled between 06/2020-08/2021. Maternal sociodemographic indicators, mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7), stress) were self-reported. Maternal mental health in pregnant women (stratified by trimester, and pandemic period/wave at recruitment) was compared with mental health of women who had delivered; determinants of severe depression were identified with multivariate logistic regression models.Results: 2,574 persons were pregnant and 626 had already delivered at recruitment. Participants who had delivered had significantly higher mean depressive symptom scores compared to those pregnant at recruitment (9.1 (SD, 5.7) vs. 8.4 (SD, 5.3), p=0.009). Among those who were pregnant at recruitment, depressive symptoms were significantly higher in women recruited in their third trimester, and those recruited during the 2nd wave of the pandemic. Maternal anxiety (aOR 1.51; 95%CI 1.44-1.59) and stress (aOR 1.35; 95%CI 1.24-1.48) were the most significant predictors of severe maternal depression (EDPS˃13) in pregnancy. Conclusion: The COVID-19 pandemic had a significant impact on maternal depression during pregnancy and in the post-partum period. Given that gestational depression/anxiety/stress have been associated with preterm birth and childhood cognitive problems, it is essential to continue following women/children, and develop strategies to reduce COVID-19’s longer-term impact.

Role of Lactobacillus reuteri DSM 17938 on Crying Time Reduction in Infantile Colic and Its Impact on Maternal Depression: A Real-Life Clinic-Based Study

Background: Infantile colic is characterized by prolonged periods of inconsolable, incessant crying and persistent fussing in an otherwise healthy infant. It is a self-limiting condition, but causes significant stress to mothers. AIM: To observe the role of Lactobacillus reuteriDSM 17938 in reducing crying time in colicky infants in routine clinical practice. Methods: This was a prospective observational multicentric clinic-based study. Each practitioner included approximately 30 infants < 5 months of age with infantile colic who were prescribed L. reuteri DSM 17938 for a period of 21 days. There were four physical consultations and two telephonic consultations. The parents were given a daily diary to record the duration of crying and fussing episodes and a questionnaire was administered during the consultations. Results: A total of 120 infants with a mean age of 56.9 ± 34.2 days were included in this 28-day study. The mean crying time as reported by the parents in the subject diary reduced from 248.2 ± 101.2 min, 95% CI: 229.45, 266.94 at baseline to 45.6 ± 79.1 min 95% CI: 31.02, 60.31 at study end (P < 0.01). The clinical response (defined as reduction of 50% in crying time) was observed in 85% of subjects at study end. The fussiness and parental perception of colic recorded during the consultations were reduced by 66% and 72%, respectively, at study end. The maternal depression scores were reduced to 63% at study end. Conclusion: L. reuteri DSM 17938 was associated with a significant reduction in crying time in colicky infants, and showed improvement in maternal depression.

Short-term Music Therapy for Families With Preterm Infants: A Randomized Trial

OBJECTIVES: To evaluate short-term effects of music therapy (MT) for premature infants and their caregivers on mother-infant bonding, parental anxiety, and maternal depression. METHODS: Parallel, pragmatic, randomized controlled-trial conducted in 7 level III NICUs and 1 level IV NICU in 5 countries enrolling premature infants (&lt;35 weeks gestational age at birth) and their parents. MT included 3 sessions per week with parent-led, infant-directed singing supported by a music therapist. Primary outcome was mother-infant bonding as measured by the Postpartum Bonding Questionnaire (PBQ) at discharge from NICU. Secondary outcomes were parents’ symptoms of anxiety measured by General Anxiety Disorder-7 (GAD-7) and maternal depression measured by Edinburgh Postpartum Depression Scale (EPDS). Group differences at the assessment timepoint of discharge from hospital were tested by linear mixed effect models (ANCOVA). RESULTS: From August 2018 to April 2020, 213 families were enrolled in the study, of whom 108 were randomly assigned to standard care and 105 to MT. Of the participants, 208 of 213 (98%) completed treatment and assessments. Participants in the MT group received a mean (SD) of 10 sessions (5.95), and 87 of 105 participants (83%) received the minimum of 6 sessions. The estimated group effect (95% confidence interval) for PBQ was −0.61 (−1.82 to 0.59). No significant differences between groups were found (P = .32). No significant effects for secondary outcomes or subgroups were found. CONCLUSIONS: Parent-led, infant-directed singing supported by a music therapist resulted in no significant differences between groups in mother-infant bonding, parental anxiety, or maternal depression at discharge.

The intergenerational transmission of maternal adverse childhood experiences on offspring’s psychiatric disorder and the mediating role of maternal depression: Results from a cross sectional study

Maternal adverse childhood experiences (ACEs) may negatively affect the mental health and development of their offspring. The purpose of this study was to investigate the association of maternal ACE and offspring’s psychiatric disorder and the mediating effect of maternal depression. The subjects included 463 mothers (42.78 ± 5.68 years) and their offspring aged 6–18 years (13.26 ± 3.90 years). Mothers reported their ACE before age 18 and completed the Beck Depression Inventory-II and Diagnostic Predictive Scales (DPS), a screening tool for offspring’s psychiatric disorder. 35.42% of subjects had at least one ACE, and 11.0% reported three or more ACEs. Higher maternal ACE scores were associated with a significantly higher prevalence of offspring’s psychiatric disorders ( p < 0.001). Household dysfunction of maternal ACE (OR = 2.263, p < 0.001) is significantly associated with offspring’s psychiatric disorder. In the mediation model in which the household dysfunction affects the number of offspring’s psychiatric disorders, the partial mediation model through maternal depression was significant. The mother’s experience of household dysfunction before the age of 18 has a significant impact on her offspring’s psychiatric disorder and supported significant mediation through maternal depression. Further research is needed to determine the mechanisms of intergenerational transmission of ACE and offspring’s psychopathology.

A Systematic Review of Longitudinal Studies Investigating the Association Between Early Life Maternal Depression and Offspring ADHD

Objective: The systematic review sought to understand the relationship between maternal depression and later ADHD in children. Method: Three databases were used to identify the studies (Medline, Web of Science and PsychInfo) resulting in 1,223 studies being screened and 14 articles being included in the review. Results: The majority of studies ( N = 11) reported a significant relationship between maternal depression (across both prenatal and postnatal periods) and ADHD symptoms in children. This relationship remained significant when temperament, or past ADHD symptoms were controlled for. Several methodological issues were identified including; overreliance on maternal report and parental ADHD not being accounted for in most studies. Conclusion: The review adds to the literature regarding the temporal relationship between maternal depression and the development of ADHD in children, and thus supports the case for improving access to mental health services for mothers as a preventative strategy in the development of child psychopathology.

Maternal Attachment Representations during Pregnancy, Perinatal Maternal Depression, and Parenting Stress: Relations to Child’s Attachment

Background: This paper aimed to explore the associations between maternal representations of attachment evaluated during pregnancy, pre and postnatal maternal depression, parenting stress and child’s attachment at 15 months after childbirth. Methods: Mothers (n = 71), and their infants participated in a longitudinal study of maternal attachment, pre and postnatal depression, parenting stress and child attachment. Adult Attachment Interview (AAI) was conducted between 24 and 26 weeks of pregnancy (Time 1), depression was assessed using the Edinburgh Perinatal Depression Scale (EPDS) (at Time 1 and 6 months after childbirth, i.e., Time 2), parenting stress was assessed using the Parenting Stress Index—Short Form (PS-SF) (at Time 2) and the Strange Situation Procedure (SSP) at child’s 15 months of age (Time 3). Results: Free-autonomous maternal classification of attachment increases the likelihood of secure child classification in her offspring, while decreases that of avoidance and ambivalence. Insecure maternal representation of attachment evaluated during pregnancy and higher levels of parenting stress at six months after childbirth was associated with higher rates of infant insecure attachment at 15 months. Conclusions: Our study validates the importance of considering maternal representations of attachment crucial in determining the quality of the caregiving environment, thereby the healthy development of children, despite the presence of other contextual risk.

Family dynamics. An exploration of parental sensitivity and depressive symptoms among mothers and fathers of toddlers

In studies of maternal sensitivity, the influence of mothers’ depressive symptomatology has been consistently highlighted. Additionally, the relevance of both maternal and paternal sensitive responses to children’s development has been recognized. However, literature regarding the dynamics of the mother-father-toddler triad is scarce. This is particularly true when understanding how parental sensitivity may be bidirectionally shaped by both parents’ (i.e., mothers’ and fathers’ depressive symptomatology) and children’s characteristics (i.e., age). Hence, the present study aims to describe and analyse the associations between parental depression, paternal sensitivity and children’s socioemotional difficulties and age with mothers’ sensitive responses to highlight the appropriateness of considering fathers’ depressive symptoms and sensitivity to better understand the impact of maternal depressive symptomatology on mothers’ sensitivity. The participants included 80 Chilean mother-father-child triads in which all children were between 1 and 3 years of age and presented some degree of socioemotional difficulty. The results reveal no differences in maternal and paternal sensitivity or higher depressive symptomatology in mothers than in fathers. Additionally, while mothers’ depression was significantly associated with their sensitivity, this was not the case for fathers. Paternal depressive symptomatology was associated with the mother’s depression. Finally, paternal sensitivity emerged as a mediator between maternal depressive symptoms and sensitivity. This result calls attention to the use of paternal variables to understand how maternal depression impacts mothers’ sensitivity and to thus develop appropriate interventions that expand the scope of such impacts from the dyad to the triad.

The Association of Maternal Emotional Status With Child Over-Use of Electronic Devices During the COVID-19 Pandemic

The quarantine during the COVID-19 pandemic may generate high levels of maternal depression/anxiety, and maternal emotional status may affect child behavioral development. Online education during the pandemic may induce child over-use of electronic-devices. However, child electronic-device over-use (especially among children under 12 who are immature in physical and mental development) during the pandemic has not attracted sufficient attention, and the association of child over-use with maternal emotional status remains unknown. Therefore, this study aims to assess the characteristics of child electronic-device over-use and the association between maternal emotional status and child over-use among 1,300 children from nurseries (&lt;3 years), kindergartens (3–6 years), and primary schools (6–12 years) in Shanghai and Wuhan during COVID-19. Mothers completed an online questionnaire (including the Self-Rating-Depression/Anxiety-Scales and Family-Environment-Scale). The use of electronic devices (mobile-phones, iPads, computers, and televisions) and online courses taken by the children were investigated. Associations of maternal emotional status with electronic-device-use by child age were analyzed. The proportions of children in nurseries, kindergartens and primary schools were 8.5, 44.5, and 47.0%, their percentages following online-courses were 24.5, 48.4, and 99.0%, and their rates of electronic-device over-use were 34.2, 62.2, and 93.4%, respectively. Significant associations were observed between higher maternal anxiety/depression levels and higher risks of mobile-phone/iPad over-use among preschoolers and primary-school students. Lower family intimacy and higher conflict levels were associated with higher maternal depression/anxiety levels and higher risks of electronic-device over-use. Our findings suggested that over-use of electronic-devices among children under 12 was common during COVID-19, especially among children ≥6 years, and online-teaching may exacerbate over-use. Maternal anxiety/depression levels were associated with over-use of portable internet-devices (mobile-phone/iPad), especially among preschoolers and school-aged students, and family environment may mediate the association. These findings may contribute to a better understanding of factors leading to over-use of electronic-device and developing strategies to decrease over-use during COVID-19.

Effectiveness health education and infant therapeutic group therapy on baby aged 0-6 months to prevent stunting risk factors: mother depression

Background: Stunting is a global and national problem that can be detected at the age of 2. Therefore, before this age, promotion efforts must be conducted to prevent stunting risk factors in the future. This study aims to determine the effect of health education and infant's Therapeutic Group Therapy on stunting's risk factor: maternal postpartum depression in Indonesia.Design and Methods: This study employed a quasi-experimental design with a pre-test and post-test with a control group. This study employed a purposive sampling technique, with 96 respondents divided into two groups. Intervention group 1 consisted of 48 people who received health education, and group 2 consisted of 48 people who received health education and infant's Therapeutic Group Therapy. The data were collected using the Depression Inventory-II (DI II) questionnaire with a bivariate analysis of the Wilcoxon test and frequency distribution.Results: The results show that health education and infant's Therapeutic Group Therapy significantly influence the risky factors in stunting: maternal depression. It can be concluded that there were significant changes in maternal postpartum depression in intervention group 1 and intervention group 2, but in intervention group 2 who got Health Promotion and Therapeutic Group Therapy (TKT) for Infants there was a bigger and more significant decrease.Conclusions: Nursing action, infants' Therapeutic Group Therapy, and health education are recommended to prevent risk factors for stunting: mother depression. The results of this study are expected to underlie the development of mental health promotion to prevent stunted against maternal depression and preventive programs. In addition, the research is expected to underly provision of curative and rehabilitative programs for stunted.