Maternal Prenatal Depressive Symptoms, Intervention and Infant Development

• In Event: Prenatal Interventions to Promote Healthy Development in Early Childhood

Abstract

Depressive symptoms experienced during pregnancy put offspring at risk for unhealthy developmental trajectories (Davis et al., 2007; Jansen et al., 2010; O’Connor et al., 2013). Study 1 examines the link between prenatal depressive symptoms and infant temperament and sleep problems. In line with most research in this field, Study 1 is correlational. Study 2 addresses this gap in the field to test whether reducing maternal depressive symptoms during pregnancy promotes healthy infant development using a randomized control trial (RCT) design.
Study 1. Methods & Results: Participants were 137 pregnant women (16% African American/Black, 73% non-Latinx White; 22% Latinx) and their 6-month-old infants (51% female). Depressive symptoms were measured via the EPDS five times during pregnancy and postnatally. Infant temperament was measured via the IBQ and sleep difficulty the BISQ. Prenatal depressive symptoms predicted higher infant negative affectivity (F(1,135) = 7.51, p < .01) and lower regulation (F(1, 135) = 15.33, p < .001) even after covarying for postnatal depressive symptoms. Negative affectivity and regulation mediated the relation between prenatal depression and infant sleep difficulty, suggesting increases in difficulty in bedtime with higher prenatal depression mediated through elevated negative affectivity (boot = .01, SE = .01, 95% CI = [.0012, .0238]) and reduced regulation (boot = .01, SE = .01, 95% CI = [.0034, .0260]).
Conclusion: Results of the Study 1 suggest that prenatal maternal depression is associated with higher infant negative affectivity and poor self-regulation and sleep at 6 months above and beyond postnatal maternal depressive symptoms. These results show the importance of prenatal environment in contributing to offspring development and support the fetal programming hypothesis. A limitation of this research is the reliance on correlational designs. We therefore test the impact of reducing maternal depression on infant development using an RCT design. Study 2 reports analyses from the RCT using inter-personal psychotherapy to reduce prenatal maternal depression.
Study 2. Methods & Results: At the time of interim blinded analysis 80 pregnant women with elevated depression symptoms had been randomized to intervention and 80 to care as usual. Women in the trial were English-speaking with a singleton pregnancy, primarily low-income (81% living below the federal poverty line) and representing diverse racial/ethnic backgrounds (15% African American/Black, 49% non-Latinx White, 8% American Indian/Alaska Native, 6% Asian, 3% multiracial; 27% Latinx). Depressive symptoms were measured via the SCL20 over pregnancy. Blinded analyses indicated that Group A had a significant decrease in depressive symptoms over pregnancy with a moderate effect size as compared to Group B (d = .46, p < .01).
Conclusion: Blinded analyses of the RCT show significant reduction in depressive symptoms over pregnancy in one of the groups. These findings suggest that the intervention effectively impacted maternal prenatal depression symptoms. We currently are following mothers and infants through 18 months postpartum with assessments of brain development (MRI and ERP), stress physiology, eye tracking, behavioral and parent report measures of temperament, cognitive function and sleep. Future directions include evaluation of reducing maternal depression on infant neurobiological risk pathways using these measures.

Authors

• Ozlu Aran
  Presenting Author

• Sarah Garcia, University of Denver
  Non-Presenting Author

• Nancy Grote, University Of Washington
  Non-Presenting Author

• Camille Hoffman, University of Colorado Anschutz Medical Campus
  Non-Presenting Author

• Benjamin Hankin, University of Illinois at Urbana-Champaign
  Non-Presenting Author

• Elysia Davis, University of Denver
  Non-Presenting Author