Maternal Depression and Anxiety Across the Postpartum Year and Infant Social Engagement, Fear Regulation, and Stress Reactivity
Abstract
Objective To examine the effects of maternal depression on infant social engagement, fear regulation, and cortisol reactivity as compared with maternal anxiety disorders and controls and to assess the role of maternal sensitivity in moderating the relations between maternal depression and infant outcome.Method Using an extreme-case design, 971 women reported symptoms of anxiety and depression after childbirth and 215 of those at the high and low ends were reevaluated at 6 months. At 9 months, mothers diagnosed with a major depressive disorder (n = 22) and anxiety disorders (n = 19) and matched controls reporting no symptoms across the postpartum year (n = 59) were visited at home. Infant social engagement was observed during mother-infant interaction, emotion regulation was microcoded from a fear paradigm, and mother's and infant's cortisol were sampled at baseline, reactivity, and recovery.Results The infants of depressed mothers scored the poorest on all three outcomes at 9 months-lowest social engagement, less mature regulatory behaviors and more negative emotionality, and highest cortisol reactivity-with anxious dyads scoring less optimally than the controls on maternal sensitivity and infant social engagement. Fear regulation among the children of anxious mothers was similar to that of the controls and their stress reactivity to infants of depressed mothers. Effect of major depressive disorder on social engagement was moderated by maternal sensitivity, whereas two separate effects of maternal disorder and mother sensitivity emerged for stress reactivity.Conclusions Pathways leading from maternal depression to infant outcome are specific to developmental achievement. Better understanding of such task-specific mechanisms may help devise more specifically targeted interventions.
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Infants of depressed mothers have significantly higher fear scores than infants of nondepressed mothers.
“Infants of depressed mothers also had a significantly higher fear score115,121 and higher degrees of emotional disorders that included anxiety96 than infants of nondepressed mothers.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
The effect of maternal major depressive disorder on social engagement is moderated by maternal sensitivity.
“In this study, the effect of MDD on social engagement was moderated by maternal sensitivity.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
Infants of depressed mothers have lower social engagement scores at 9 months than infants of nondepressed mothers.
“One study indicated that the infants of depressed mothers had lower social engagement scores at 9 months than infants of nondepressed mothers.115”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
Maternal postpartum depression is associated with less mature regulatory behaviors in infants.
“less mature regulatory behaviors,115”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
More negative emotionality and the highest cortisol reactivity were noted in anxious dyads, which received lower scores for maternal sensitivity and infant social engagement than the controls.
“More negative emotionality and the highest cortisol reactivity were noted in anxious dyads, which received lower scores for maternal sensitivity and infant social engagement than the controls.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
The infants of depressed mothers scored the worst on all outcomes at 9 months.
“The infants of depressed mothers scored the worst on all outcomes at 9 months.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [115]
Untreated postpartum mood and anxiety disorders (PMADs) are associated with adverse personal and public health consequences for mothers, children, and families.
“Untreated postpartum mood and anxiety disorders (PMADs) place women and their families at risk for negative biopsychosocial sequelae.”
From Motherhood and Me (Mom-Me): The Development of an Acceptance-Based Group for Women with Postpartum Mood and Anxiety Symptoms (2022) · cites this paper as [9]
Children of women with PMADs are at risk for long-term cognitive, behavioral, and emotional deficits that can last through adulthood.
“These children are at risk for long-term cognitive, behavioral, and emotional deficits that can last through adulthood [9].”
From Motherhood and Me (Mom-Me): The Development of an Acceptance-Based Group for Women with Postpartum Mood and Anxiety Symptoms (2022) · cites this paper as [9]
Effect of major depressive disorder on social engagement and child stress-reactivity were moderated by maternal sensitivity behavioral measures.
“Interestingly, the effect of major depressive disorder on social engagement and child stress-reactivity were moderated by maternal sensitivity behavioral measures, which have also been reported to be related to cortical parental brain responses to their infant cry (Kim et al., 2010a).”
From The human parental brain: In vivo neuroimaging (2011) · cites this paper as Feldman et al., 2009
Infants of control, anxious and depressed mothers had poorer outcomes at 9 months postpartum, with diminished social engagement, maturity of regulatory behaviors and more emotionality, and increased cortisol reactivity.
“In another recent study (Feldman et al., 2009), infants of control, anxious and depressed mothers were compared with respectively poorer outcomes at 9 months postpartum. Social engagement, maturity of regulatory behaviors and more emotionality were all diminished by mood and anxiety, with associated increases in cortisol reactivity.”
From The human parental brain: In vivo neuroimaging (2011) · cites this paper as Feldman et al., 2009
Abnormally low levels of parental preoccupation, e.g. in postpartum depression, also pose difficulties in developing emotional bonds with the infant, and risk inadequate parenting.
“Abnormally low levels of parental preoccupation, e.g. in postpartum depression also pose difficulties in developing emotional bonds with the infant, and risk inadequate parenting (Feldman et al., 2009; Feldman et al., 1999).”
From Approaching the biology of human parental attachment: Brain imaging, oxytocin and coordinated assessments of mothers and fathers (2014) · cites this paper as Feldman et al., 2009
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Simons, S. S. H., Zijlmans, M. A. C., Cillessen, A. H. N., & de Weerth, C. (2019) · Stress · doi:10.1080/10253890.2019.1608945 · Cited by 28 · see citing works
Spieker, S. J., Oxford, M. L., Fleming, C. B., & Lohr, M. J. (2018) · Infant Mental Health Journal · doi:10.1002/imhj.21685 · Cited by 27 · see citing works
Nephew, B., Murgatroyd, C., Pittet, F., & Febo, M. (2015) · Journal of Reward Deficiency Syndrome · doi:10.17756/jrds.2015-017 · Cited by 20 · see citing works
Psychogiou, L., Ahun, M. N., Boivin, M., Tremblay, R. E., Orri, M., & Côté, S. M. (2022) · Development and Psychopathology · doi:10.1017/s0954579420001753 · Cited by 18 · see citing works
Grunberg, V. A., Geller, P. A., Durham, K., Bonacquisti, A., & Barkin, J. L. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11092345 · Cited by 11 · see citing works
“These children are at risk for long-term cognitive, behavioral, and emotional deficits that can last through adult-hood [9].”
Background
- Authors
- Feldman, R., Granat, A., Pariente, C., Kanety, H., Kuint, J., & Gilboa-Schechtman, E.
- Affiliations
- Bar-Ilan University (IL)
- Corresponding author
- Feldman, Ruth
- ORCID
- Feldman, Ruth
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 48
- Issue
- 9
- Pages
- 919-927
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W1981559145
- Cited by
- 747
- References
- 52
- Citations by year
- 2026: 18 · 2025: 39 · 2024: 54 · 2023: 44 · 2022: 58 · 2021: 59 · 2020: 90 · 2019: 60 · 2018: 52 · 2017: 47 · 2016: 37 · 2015: 42 · 2014: 41 · 2013: 37 · 2012: 24
- FWCI
- 23.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (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 › Pharmacy › Infant Health and Development
- Keywords
- maternal depression, maternal anxiety disorders, postpartum depression, cortisol response, stress reactivity, maternal sensitivity, mother-infant interaction, infant negative emotionality, emotion regulation
- MeSH terms
- Adaptation, Psychological, Arousal, Major Depressive Disorder, Fear, Female, Follow-Up Studies, Humans, Hydrocortisone, Infant, Male, Maternal Behavior, Mother-Child Relations, Personality Assessment, Puerperal Disorders, Social Behavior, Depression, Postpartum
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