Postnatal maternal depressive symptoms and behavioural outcomes in term-born and preterm-born toddlers: a longitudinal UK community cohort study.

Kleine, Ira; Vamvakas, George; Lautarescu, Alexandra; Falconer, Shona; Chew, Andrew; Counsell, Serena; Pickles, Andrew; Edwards, David et al. · BMJ Open · 2022

prospective_cohort · Level II

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Abstract

To examine the association between maternal depressive symptoms in the immediate postnatal period and offspring's behavioural outcomes in a large cohort of term-born and preterm-born toddlers. Data were drawn from the Developing Human Connectome Project. Maternal postnatal depressive symptoms were assessed at term-equivalent age, and children's outcomes were evaluated at a median corrected age of 18.4 months (range 17.3-24.3). Preterm birth was defined as <37 weeks completed gestation. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS). Toddlers' outcome measures were parent-rated Child Behaviour Checklist 1<sup>1/2</sup>-5 Total (CBCL) and Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores. Toddlers' cognition was assessed with the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Higher maternal EPDS scores were associated with toddlers' higher CBCL (B=0.93, 95% CI 0.43 to 1.44, p<0.001, f<sup>2</sup>=0.05) and Q-CHAT scores (B=0.27, 95% CI 0.03 to 0.52, p=0.031, f<sup>2</sup>=0.01). Maternal EPDS, toddlers' CBCL and Q-CHAT scores did not differ between preterm (n=97; 19.1% of the total sample) and term participants. Maternal EPDS score did not disproportionately affect preterm children with respect to CBCL or Q-CHAT scores. Our findings indicate that children whose mothers reported increased depressive symptoms in the early postnatal period, including subclinical symptoms, exhibit more parent-reported behavioural problems in toddlerhood. These associations were independent of gestational age. Further research is needed to confirm the clinical significance of these findings.

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