Maternal Depression During Pregnancy and the Postnatal Period: Risks and Possible Mechanisms for Offspring Depression at Age 18 Years
Open accessAbstract
IMPORTANCE: Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention. OBJECTIVE: To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. DESIGN, SETTING, AND PARTICIPANTS: Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring. MAIN OUTCOMES AND MEASURES: Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision. RESULTS: Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression. CONCLUSIONS AND RELEVANCE: The findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.
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This may leave women at increased risk of both PTB and postpartum depression, which has long-term effects for mother and child.
“This may leave women at increased risk of both PTB and postpartum depression, which has long-term effects for mother and child [17].”
From The mastery lifestyle intervention to reduce biopsychosocial risks for pregnant Latinas and African Americans and their infants: protocol for a randomized controlled trial (2022) · cites this paper as [17]
The Abstract Results and Conclusions link maternal postnatal depression to offspring depression at age 18, supporting a long-term effect on children, particularly where mothers have low education. The paper does not establish the claimed increased risk of preterm birth or long-term effects on mothers; preterm birth appears only in the title of a cited reference. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredChildren of mothers with antepartum depression have a higher risk of suffering from depression later in life.
“and they have a higher risk of suffering from depression later in life.13”
From Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial (2020) · cites this paper as [13]
Prenatal depression appears to affect infant and child development and may increase the risk of developing depression in adulthood.
“Furthermore, prenatal depression appears to affect infant and child development and may increase the risk of developing depression in adulthood (17, 22).”
From Acceptance, experiences, and needs of hospitalized pregnant women toward an electronic mindfulness-based intervention: A pilot mixed-methods study (2022) · cites this paper as [22]
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- Authors
- Pearson, R. M., Evans, J., Kounali, D., Lewis, G., Heron, J., Ramchandani, P. G., O’Connor, T. G., & Stein, A.
- Affiliations
- University of Bristol (GB)
- Imperial College London (GB)
- University of Rochester Medicine (US)
- University of Oxford (GB)
- ORCID
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2013-12-01
- Volume
- 70
- Issue
- 12
- Pages
- 1312
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC3930009
- OpenAlex
- W2112790937
- Cited by
- 589
- References
- 44
- Citations by year
- 2026: 25 · 2025: 34 · 2024: 42 · 2023: 34 · 2022: 48 · 2021: 56 · 2020: 62 · 2019: 61 · 2018: 54 · 2017: 44 · 2016: 40 · 2015: 49 · 2014: 38 · 2013: 2
- FWCI
- 43.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- Wellcome Trust (076467/Z/05/Z, 090139, 084268, 084268/Z/07/Z)
- National Institute of Mental Health (R01MH073842)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal depression, antenatal depression, postpartum depression, offspring depression, adolescent depression, major depressive disorder, maternal education, socioeconomic deprivation, paternal depression, depression prevention, Avon Longitudinal Study of Parents and Children
- MeSH terms
- Adolescent, Adult, Major Depressive Disorder, Educational Status, England, Female, Humans, Male, Middle Aged, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Risk Factors, Cohort Studies, Odds Ratio, Depression, Postpartum
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