Vulnerable babies, vulnerable moms: Bidirectional associations of depression in mother-preterm infant dyads through age 6

• In Event: Poster Session 08
  In Poster Session: PS 08 Topic - Developmental Psychopathology

Abstract

The premature birth of an infant (<37 weeks gestation) is often a source of significant emotional distress for a family due to the increased stress of pregnancy and birth complications, worries about the infant’s health, lack of physical contact between mother and child, and additional medical complications and interventions (Yaari et al., 2017). Consequently, mothers of preterm infants are at risk for experiencing distress and depressive symptoms within the first months of the child’s birth. Indeed, previous studies identify increased rates of postnatal depressive symptoms for mothers of high risk infants (i.e., preterm, low birth weight) compared to mothers of full-term infants (Vigod et al., 2010), with some studies finding increases lasting 1 to 2 years postnatal and into children’s early adolescence. When the symptoms continue, they may have an impact on children’s well-being, especially on the development of childhood depressive disorders (Goodman et al., 2011). When children’s depressive symptoms are elevated, it may further exacerbate maternal mood and psychological distress as children grow older (Elgar et al., 2004), creating the potential for transactional, dyadic mother- and child-effects over time. In this analysis of prospective, longitudinal data with children born preterm and their families, we examine bidirectional processes relating to mother and child depressive symptoms from toddlerhood to 6 years of age.
The sample consisted of 181 mother-child dyads who were assessed from the time the infants were in the special care nursery to 6 years old (see Table 1). Mothers’ ages at hospital discharge ranged from 17-42 years old (M=29.6, SD=6.2), and 81.2% were living with a spouse or partner at hospital discharge. Household income at hospital discharge ranged $0-$500,000 (M=59,076, SD=52,837), with 37.3% receiving public assistance. Infant gestational age ranged from very preterm (<32 weeks, 47.4%), moderate preterm (32-33 weeks, 24.9%), and late preterm (34-36 weeks, 27.7%). Maternal depressive symptoms (CES-D, Radloff, 1977) and maternal reports of child depressive symptoms (Affective Symptoms on the CBCL Preschool and School Age forms, Achenbach & Rescorla, 2001, 2007) were measured at four time points (16, 24, and 36 months corrected for prematurity, and 6 years old). All results control for demographic risk (e.g., maternal age, household income, maternal education) and child gender.
Results using autoregressive cross-lagged models in structural equation modeling (see Figure 1) indicated that maternal depressive symptoms at 24 months directly related to child depressive symptoms at 36 months (B=.17, p=.017), though maternal depressive symptoms at 16 months relating to child depressive symptoms at 24 months also trended towards significance (B=.14, p=.054). Elevated child depressive symptoms at 36 months directly related to elevated maternal symptoms when children were 6 years of age (B=.19, p=.006). These results suggest the presence of both mother- and child-effects on depressive symptoms over time, where maternal depressive symptoms influence child depressive symptoms and vice versa. Implications for future research and intervention with preterm children and their families will be discussed.

Authors

• Kerrie Fanning, University of Wisconsin - Madison
  Presenting Author

• Emily D. Gerstein, University of Missouri-St. Louis
  Non-Presenting Author

• Julie A. Poehlmann-Tynan, University of Wisconsin - Madison
  Non-Presenting Author