Association of maternal depression and anxiety with toddler social-emotional and cognitive development in South Africa: a prospective cohort study.

Journal: BMJ open

Volume: 12

Issue: 4

Year of Publication: 2022

Affiliated Institutions:  Psychiatry, Columbia University Irving Medical Center, New York City, New York, USA lcg@cumc.columbia.edu. Psychiatry, Columbia University Irving Medical Center, New York City, New York, USA. Department of Applied Psychology, New York University, New York City, New York, USA. Obstetrics and Gynaecology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa. Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa. Neuroscience, New York State Psychiatric Institute, New York City, New York, USA. Department of Obstetrics and Gynaecology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa. Obstetrics & Gynaecology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.

Abstract summary 

A robust literature has identified associations between prenatal maternal depression and adverse child social-emotional and cognitive outcomes. The majority of prior research is from high-income countries despite increased reporting of perinatal depression in low/middle-income countries (LMICs). Additionally, despite the comorbidity between depression and anxiety, few prior studies have examined their joint impact on child neurodevelopment. The objective of the current analysis was to examine associations between prenatal maternal depression and anxiety with child social-emotional and cognitive development in a cohort from the Western Cape Province of South Africa.Prenatal maternal depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory Scale at 20-24 weeks' gestation. Child neurobehaviour was assessed at age 3 using the Brief Infant-Toddler Social Emotional Assessment and the Bayley Scales of Infant Development III Screening Test (BSID-III ST). We used linear regression models to examine the independent and joint association between prenatal maternal depression, anxiety and child developmental outcomes.Participants consisted of 600 maternal-infant dyads (274 females; gestational age at birth: 38.89 weeks±2.03). Children born to mothers with both prenatal depression and trait anxiety had higher social-emotional problems (mean difference: 4.66; 95% CI 3.43 to 5.90) compared with children born to mothers with no prenatal depression or trait anxiety, each condition alone, or compared with mothers with depression and state anxiety. Additionally, children born to mothers with prenatal maternal depression and trait anxiety had the greatest reduction in mean cognitive scores on the BSID-III ST (mean difference: -1.04; 95% CI -1.99 to -0.08).The observed association between comorbid prenatal maternal depression and chronic anxiety with subsequent child social-emotional and cognitive development underscores the need for targeting mental health support among perinatal women in LMICs to improve long-term child neurobehavioural outcomes.

Authors & Co-authors:  Shuffrey Lauren C LC Sania Ayesha A Brito Natalie H NH Potter Mandy M Springer Priscilla P Lucchini Maristella M Rayport Yael K YK Du Plessis Carlie C Odendaal Hein J HJ Fifer William P WP

Study Outcome 

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Citations :  O'Donnell KJ, Meaney MJ. Fetal origins of mental health: the developmental origins of health and disease hypothesis. Am J Psychiatry 2017;174:319–28. 10.1176/appi.ajp.2016.16020138
Authors :  10
Identifiers
Doi : e058135
SSN : 2044-6055
Study Population
Women,Mothers
Mesh Terms
Anxiety
Other Terms
Anxiety disorders;Child & adolescent psychiatry;Community child health;Depression & mood disorders
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England