Conflict of interest statement: No conflicts declared.
Antepartum and postpartum exposure to maternal depression: different effects on different adolescent outcomes
Article first published online: 13 OCT 2008
© 2008 The Authors. Journal compilation © 2008 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Volume 49, Issue 10, pages 1079–1088, October 2008
How to Cite
Hay, D. F., Pawlby, S., Waters, C. S. and Sharp, D. (2008), Antepartum and postpartum exposure to maternal depression: different effects on different adolescent outcomes. Journal of Child Psychology and Psychiatry, 49: 1079–1088. doi: 10.1111/j.1469-7610.2008.01959.x
- Issue published online: 13 OCT 2008
- Article first published online: 13 OCT 2008
- Manuscript accepted 29 February 2008
- Postpartum depression;
- antepartum depression;
- maternal anxiety;
- adolescent psychopathology;
- disruptive behaviour;
- emotional disorder
Background: Postpartum depression (PPD) is considered a major public health problem that conveys risk to mothers and offspring. Yet PPD typically occurs in the context of a lifelong episodic illness, and its putative effects might derive from the child’s exposure to other episodes, in pregnancy or later childhood. The aim of the study is to test two hypotheses: (1) that the effects of PPD on adolescent outcomes are partly explained by antepartum depression (APD) and (2) that the effects of APD and PPD are both explained by later exposure to the mother’s depression.
Method: A random sample of 178 antenatal patients was drawn from two general medical practices in South London; 171 gave birth to live infants, and 150 (88%) were assessed at 3 months post partum, with 121 of their offspring (81%) assessed for emotional disorders (ED), disruptive behaviour disorders (DBD) and IQ, at 11 and 16 years of age.
Results: When APD and subsequent episodes of depression were taken into account, PPD had a significant effect on adolescent IQ, especially for boys, but did not predict psychopathology. ED and DBD in adolescence were predicted by the extent of exposure to maternal depression after 3 months post partum; a significant effect of APD on ED in girls was accounted for by later exposure to the mother’s illness. Mothers’ symptoms of anxiety, smoking and alcohol use in pregnancy did not predict adolescent outcomes, once maternal depression was taken into account.
Conclusions: Some effects attributed to mothers’ mental health problems in pregnancy or post partum may be mediated by cumulative exposure to maternal illness, probably reflecting genetic influence and gene–environment correlation. However, PPD has a direct effect on cognition. Clinicians should endeavour to identify women with depression in pregnancy (31% of this sample) and help them to manage their lifelong illness.