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Cited by 312Maternal Mental Health During Pregnancy and PostpartumChild and Adolescent Psychosocial and Emotional DevelopmentMaternal and Neonatal Healthcare

Maternal depression and child development

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Bernard-Bonnin, A-C, Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee·2004·Paediatrics & Child Health
DOI 10.1093/pch/9.8.575PMC PMC2724169
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Abstract

Maternal depression is considered a risk factor for the socioemotional and cognitive development of children [1]. The current prevalence of depression in Canada averages at 6%, which is similar to the rates in other western countries [2] (the female-to-male ratio average is 2:1 [3]). However, the prevalence of postpartum depression is approximately 13% [4]. Women of childbearing age are particularly at risk for depression, and many of them experience high levels of social morbidity and depressive symptoms that are often unrecognized and untreated. Mothers already at risk for depression are particularly fragile during the first months postpartum. Maternal depression has consequences on the child’s development. Because physicians who care for infants and children encounter mothers repeatedly, it is important that they have the knowledge and skills for the detection of symptoms of maternal depression. The objectives of this statement are: To review the present knowledge on the consequences of maternal depression on the development of children at various ages; To review the evidence-based literature on the treatment of maternal depression and its impact on newborns, infants and children; and To review the role of the child’s physician in the detection of symptoms of maternal depression, and the coordination of appropriate support and management. A literature search for the past 15 years was conducted using the MEDLINE database, and by reviewing the bibliographies of the retrieved articles. Of particular interest were the prospective longitudinal cohort studies in which mothers were recruited during their pregnancy or postpartum period, and the children were assessed at regular intervals. Postpartum psychiatric disorders are generally divided into three categories: postpartum blues, postpartum psychosis and postpartum depression. Postpartum blues is a relatively common emotional disturbance with crying, confusion, mood lability, anxiety and depressed mood. The symptoms appear during the first week postpartum, last for a few hours to a few days and have few negative sequelae. At the other end of the spectrum, postpartum psychosis refers to a severe disorder beginning within four weeks postpartum, with delusions, hallucinations and gross impairment in functioning. Postpartum depression begins in or extends into the postpartum period and core features include dysphoric mood, fatigue, anorexia, sleep disturbances, anxiety, excessive guilt and suicidal thoughts [5]. The diagnosis requires that symptoms be present for at least one month and result in some impairment in the woman’s functioning [6]. Women who have experienced postpartum depression have a 50% to 62% risk for future depressions [7]. Other risk factors for postpartum depression include a history of mood disorders, depression symptoms during the pregnancy and a family history of psychiatric disorders [4]. Stress factors, such as negative life events, poor marital relationships, having a special needs infant or medically ‘fragile’ infant, lack of social support, drug abuse, and personal and family psychopathology, have been associated with postpartum depression in some studies, but other studies have found no association [6]. Postpartum depression tends to be milder than episodes of depression that occur at other times, with lower levels of anxiety, agitation, insomnia and somatic symptoms [8]. However, the duration seems to be the same in postpartum and nonpostpartum depression, and lasts several months [6]. The consequences on the child of maternal postpartum depression are not restricted to infancy, but can extend into toddlerhood, preschool age and even school age. Maternal depression that occurs later influences the development of the school-age child and the adolescent. Table 1 summarizes the consequences of maternal depression from prenatal issues to adolescence. Consequences of maternal depression Consequences of maternal depression The associations between maternal depression, maternal behaviour and child outcomes are complex, and not all studies have found a relationship between maternal depression and indicators of poor parenting. Variations in the type, severity, chronicity and timing of maternal depression [9], heterogeneity in sampling (community versus high-risk multiproblem samples), and potentiating risk factors, such as family adversity, low social support and financial stress [10], all contribute to differences in outcomes in children. On the other hand, stress factors can be responsible for adverse child outcomes in the absence of maternal depression. On a daily basis, infants repeatedly participate in interactive routines with their mothers. Maternal depression compromises the dyad’s capacity to mutually regulate the interaction, through two interactive patterns, intrusiveness or withdrawal. Intrusive mothers display a hostile affect, and disrupt the infant’s activity. The infants experience anger, turn away from the mother to limit her

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  • Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers, compared to mothers without PPD, include poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.

    “Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers (compared to mothers without PPD) include problems such as poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.5,10–17”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [17]

    The Conclusions and Table 1 (page not indicated in our copy) describe poorer cognitive functioning, externalizing problems, and psychiatric disorders among children of depressed mothers, including adolescents. The paper also describes psychosocial maladjustment and aggressive behaviour, but does not establish the full list as risks specifically of *untreated* postpartum depression versus mothers without it; it does not identify adolescent medical disorders as an outcome. (LLM, conf=0.86)

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  • Untreated PPD seems to have negative consequences for both infants and mothers.

    “Untreated PPD seems to have negative consequences for both infants and mothers.”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [17]

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Research works printed but not linked: 2

  1. [70]Malphurs J, Larrain C, Field T, et al. Altering withdrawn and intrusive interaction behaviors of depressed mothers. Infant Ment Health J. 1996;17:152–60. [Google Scholar]
  2. [85]Feightner JW. Canadian Task Force on the Periodic Health Examination Canadian Guide to Clinical Preventive Health Care. Ottawa: Health Canada; 1994. Early detection of depression; pp. 450–4. [Google Scholar]

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Authors
Bernard-Bonnin, A.-C., Canadian Paediatric Society, & Mental Health and Developmental Disabilities Committee
Venue
Paediatrics & Child Health
Publisher
Oxford University Press (OUP)
Published
2004-10-01
Volume
9
Issue
8
Pages
575-583
ISSN
  • 1205-7088 (ISSN-L)
  • 1918-1485
DOI
10.1093/pch/9.8.575
PMC
PMC2724169
OpenAlex
W2245240757
Cited by
312
References
105
Citations by year
2026: 19 · 2025: 35 · 2024: 39 · 2023: 28 · 2022: 34 · 2021: 39 · 2020: 19 · 2019: 10 · 2018: 25 · 2017: 16 · 2016: 7 · 2015: 12 · 2014: 6 · 2013: 5 · 2012: 2
FWCI
1.01
Type
journal article
Language
en
Open access
Locations
  • Paediatrics & Child Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
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, postpartum depression, child development, social-emotional development, cognitive development, postpartum psychosis, postpartum blues, maternal depression treatment, antidepressant use in pregnancy, infant development, depression screening, maternal mental health, risk factors for depression, antenatal depression, postpartum depression screening, postpartum depression treatment, postpartum depression recurrence

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