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Maternal mental health and infant emotional reactivity: a 20-year two-cohort study of preconception and perinatal exposures

Published online by Cambridge University Press:  10 April 2019

Elizabeth Spry Open the ORCID record for Elizabeth Spry [Opens in a new window] ,
Margarita Moreno-Betancur ,
Denise Becker ,
Helena Romaniuk ,
John B. Carlin ,
Emma Molyneaux ,
Louise M. Howard ,
Joanne Ryan ,
Primrose Letcher  and
Jennifer McIntosh
...Show all authors
Elizabeth Spry*
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
Margarita Moreno-Betancur
Affiliation:
Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Australia
Denise Becker
Affiliation:
Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
Helena Romaniuk
Affiliation:
Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia Deakin University Burwood, Biostatistics Unit, Faculty of Health, Melbourne, Australia
John B. Carlin
Affiliation:
Murdoch Children's Research Institute, Clinical Epidemiology & Biostatistics Unit; Melbourne, Australia The University of Melbourne, Melbourne School of Population and Global Health, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia
Emma Molyneaux
Affiliation:
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience; King's College London, UK & South London and Maudsley NHS Foundation Trust, UK
Louise M. Howard
Affiliation:
Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience; King's College London, UK & South London and Maudsley NHS Foundation Trust, UK
Joanne Ryan
Affiliation:
Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
Primrose Letcher
Affiliation:
Department of Paediatrics, The University of Melbourne, Victoria, Australia
Jennifer McIntosh
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
Jacqui A. Macdonald
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia
Christopher J. Greenwood
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
Kimberley C. Thomson
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia
Helena McAnally
Affiliation:
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
Robert Hancox
Affiliation:
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
Delyse M. Hutchinson
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Australia
George J. Youssef
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
Craig A. Olsson
Affiliation:
Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia
George C. Patton
Affiliation:
Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia Department of Paediatrics, The University of Melbourne, Victoria, Australia
*
Author for correspondence: Elizabeth Spry, E-mail: elizabeth.spry@mcri.edu.au
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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.

Keywords

Adolescenceinfant behaviourinfant temperamentintergenerational transmissionmaternal mental healthperinatalpreconceptionprepregnancy
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 5 , April 2020 , pp. 827 - 837
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

Joint senior authors

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