CoChat
Sign Up
Cited by 632Maternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal HealthcareChild and Adolescent Psychosocial and Emotional Development

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Association of Persistent and Severe Postnatal Depression With Child Outcomes

Open access
Netsi, Elena, Pearson, Rebecca M., Murray, Lynne, Cooper, Peter, Craske, Michelle G., Stein, Alan·2018·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2017.4363PMC PMC5885957
Open this paper in CoChat — free accountOpen PDF

Abstract

Importance: Maternal postnatal depression (PND) is common and associated with adverse child outcomes. These effects are not inevitable, and it is critical to identify those most at risk. Previous work suggests that the risks of adverse outcomes are increased when PND is severe and persistent, but this has not been systematically studied. Objective: To examine the association between differing levels of persistence and severity of PND and long-term child outcomes. Design, Setting, and Participants: The sample for this observational study comprised participants in the Avon Longitudinal Study of Parents and Children in the United Kingdom. Three thresholds of PND severity-moderate, marked, and severe-were defined using the self-rated Edinburgh Postnatal Depression Scale (EPDS). Depression was defined as persistent when the EPDS score was above the threshold level at both 2 and 8 months after childbirth. For each of these severity and persistence categories, the following were examined: (1) the trajectories of later EPDS scores (6 time points between 21 months and 11 years after childbirth) and (2) child outcomes-behavioral problems at 3.5 years of age, school-leaving mathematics grades at 16 years of age, and depression at 18 years of age. Data analysis was conducted from July 12, 2016, to February 8, 2017. Main Outcomes and Measures: Child behavioral problems at 3.5 years of age using the Rutter total problems scale, school-leaving mathematics grades at 16 years of age extracted from records of external national public examinations, and offspring depression at 18 years of age using the Clinical Interview Schedule-Revised. Results: For the 9848 mothers in the sample, the mean (SD) age at delivery was 28.5 (4.7) years. Of the 8287 children, 4227 (51%) were boys and 4060 (49%) were girls. Compared with women with PND that was not persistent and women who did not score above the EPDS threshold, for all 3 severity levels, women with persistent PND showed elevated depressive symptoms up to 11 years after childbirth. Whether persistent or not, PND doubled the risk of child behavior disturbance. The odds ratio (OR) for child behavioral disturbance for mothers with moderate PND was 2.22 (95% CI, 1.74-2.83), for mothers with marked PND was 1.91 (95% CI, 1.36-2.68), and for mothers with severe PND was 2.39 (95% CI, 1.78-3.22). Persistence of severe PND was particularly important to child development, substantially increasing the risk for behavioral problems at 3.5 years of age (OR, 4.84; 95% CI, 2.94-7.98), lower mathematics grades at 16 years of age (OR, 2.65; 95% CI, 1.26-5.57), and higher prevalence of depression at 18 years of age (OR, 7.44; 95% CI, 2.89-19.11). Conclusions and Relevance: Persistent and severe PND substantially raises the risk for adverse outcome on all child measures. Meeting criteria for depression both early and late in the postnatal year, especially when the mood disturbance is severe, should alert health care professionals to a depression that is likely to be persistent and to be associated with an especially elevated risk of multiple adverse child outcomes. Treatment for this group should be prioritized.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2017.4363

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 38 references

Research works printed but not linked: 1

  1. [25]Elander J, Rutter M Use and development of the Rutter parents’ and teachers’ scales. Int J Methods Psychiatr Res. 1996; 6(2): 63- 78.

Cited by

Sorted by citations

Items 401–500 of 631

Related

See all

Metadata

Authors
Netsi, E., Pearson, R. M., Murray, L., Cooper, P., Craske, M. G., & Stein, A.
Affiliations
  • University of Oxford (GB)
  • University of Bristol (GB)
  • University of Cape Town (ZA)
  • University of California, Los Angeles (US)
  • University of the Witwatersrand (ZA)
Corresponding author
Stein, Alan
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2018-03-01
Volume
75
Issue
3
Pages
247
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2017.4363
PMC
PMC5885957
OpenAlex
W2787927462
Cited by
632
References
38
Citations by year
2026: 54 · 2025: 60 · 2024: 102 · 2023: 81 · 2022: 86 · 2021: 99 · 2020: 71 · 2019: 57 · 2018: 21
FWCI
59.12
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion, other-oa)
  • CentAUR (University of Reading) (submittedVersion)
Funders
  • Wellcome Trust (102215/2/13/2))
  • National Institute for Health and Care Research
  • Medical Research Council (MC_PC_15018)
  • Economic and Social Research Council (ES/P009794/1)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
postpartum depression, depression severity, child behavior problems, offspring depression, maternal mental health, long-term child outcomes, Avon Longitudinal Study of Parents and Children, Edinburgh Postnatal Depression Scale, academic performance
MeSH terms
Adolescent, Child, Child Behavior Disorders, Chronic Disease, Depression, Educational Status, Female, Humans, Infant, Infant, Newborn, Longitudinal Studies, Male, Mother-Child Relations, Risk, Cohort Studies, Child of Impaired Parents, Outcome Assessment, Health Care, Depression, Postpartum

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review