Maternal mental health and infant emotional reactivity: a 20-year two-cohort study of preconception and perinatal exposures
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Abstract
Background: Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied. Methods: We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum. Results: Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4–3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure. Conclusions: Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.
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- Authors
- Spry, E., Moreno-Betancur, M., Becker, D., Romaniuk, H., Carlin, J. B., Molyneaux, E., Howard, L. M., Ryan, J., Letcher, P., McIntosh, J., Macdonald, J. A., Greenwood, C. J., Thomson, K. C., McAnally, H., Hancox, R., Hutchinson, D. M., Youssef, G. J., Olsson, C. A., & Patton, G. C.
- Affiliations
- Deakin University (AU)
- Murdoch Children's Research Institute (AU)
- The University of Melbourne (AU)
- King's College London (GB)
- Monash University (AU)
- University of Otago (NZ)
- Corresponding author
- Spry, Elizabeth
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019-04-10
- Volume
- 50
- Issue
- 5
- Pages
- 827-837
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2936994761
- Cited by
- 60
- References
- 85
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 4 · 2022: 16 · 2021: 9 · 2020: 8 · 2019: 3
- FWCI
- 8.29
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Monash University Research Portal (Monash University) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, other-oa)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- OSF Preprints (OSF Preprints) (submittedVersion)
- Funders
- University of Otago
- South London and Maudsley NHS Foundation Trust
- Children’s Hospital of Wisconsin Research Institute
- Children's Hospital Foundation
- Murdoch Children's Research Institute
- National Institute for Health and Care Research (NIHR-RP-R3-12-011)
- King's College London (NIHR-RP-R3-12-011)
- Australian Rotary Health
- University of New South Wales
- Deakin University
- University of Melbourne
- State Government of Victoria
- Medical Research Council (APP1135727)
- Australian Research Council (DP180102447)
- National Health and Medical Research Council (1117873, 1135727)
- 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 mental health, differential sensitivity, perinatal depression, prenatal exposure, postpartum depression, intergenerational transmission, early childhood emotional development, mediation analysis, preventive interventions
- MeSH terms
- Adolescent, Adult, Australia, Depression, Female, Humans, Infant, Mental Health, Mothers, Pregnancy, Pregnancy Complications, Prospective Studies, Cohort Studies, Preconception Care, Infant Behavior, Depression, Postpartum, Postpartum Period, Young Adult, Peripartum Period
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