Associations between maternal depression trajectories and infant neurodevelopment at eight months

Background: Maternal depression is an increasingly recognized risk factor of child neurodevelopment difficulties. Few studies have investigated the association between the severity and duration of maternal depression and child development. We aimed to identify whether trajectories of maternal depressive symptoms from pregnancy to six months postpartum are associated with child development at eight months.

Methods: We included 988 mother-child pairs who participated in Shenzhen Birth Cohort Study, which was conducted in Shenzhen Nanshan Maternity & Child Healthcare Hospital of China. Maternal depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS) at late pregnancy, 1, 3 and 6 months postpartum. Child emotional and behavioral development were assessed by Ages and Stages Questionnaires: Social-Emotional (ASQ-se) and Ages and Stages Questionnaires-Third Edition (ASQ-3) at aged 8 months. Latent profile analysis (LPA) was used to identify the trajectories of maternal depressive symptoms. Univariate and multivariate linear regression were conducted to explore the association between the depressive symptoms trajectories and child development.

Results: Four trajectories of maternal depressive symptoms were identified by LPA: low (n = 597), subclinical (n = 91), moderately low and increasing (n = 246) and persistently high (54). Multivariable regression model showed that children of mothers with persistently high depressive symptoms were more likely to have lower scores in three ASQ-3 domains: fine motor (beta [95%C]): -2.30 [-4.32, -0.29], problem-solving (-3.72 [-5.81, -1.62]) and personal-social motor (-2.56 [-4.98, -0.15]), but higher ASQ-se scores (9.49 [5.09, 13.9]). Compared to children of mothers with low depressive symptoms, subclinical depressive symptoms were prediposed to having lower scores in two ASQ-3 domains: communication motor (-2.48 [-4.32, -0.64]) and gross motor (-2.35 [-4.2,-0.51]) and lower ASQ-se scores(4.86 [2.54, 7.18]).

Conclusion: Higher levels of maternal depression symptoms were associated with increased risk of child developmental delay, highlighting the importance of early intervention and addressing maternal depression from pregnancy through early childhood.