Anxiety and depression among pregnant mothers was associated with a greater risk of internalizing and externalizing symptoms among their children even after controlling for the child’s genetic risk for mental disorders, according to a study published this week in the Journal of the American Academy of Child & Adolescent Psychiatry.
“Our findings suggest that genetics alone do not fully account for the association between prenatal depression and child mental health,” wrote Lawrence Chen, B.Sc., and Kieran O’Donnell, Ph.D., of the Douglas Research Centre at McGill University in Canada, and colleagues.
Chen, O’Donnell, and colleagues used data from the Avon Longitudinal Study of Parents and Children, which included women who were pregnant between April 1, 1991, and December 31, 1992, and their children.
Maternal depressive symptoms were assessed when mothers were 32 weeks pregnant using the Edinburgh Postnatal Depression Scale (EPDS), while anxiety symptoms were assessed using the Crown Cusp Experiential Index (CCEI). The children’s internalizing, externalizing, and total emotional/behavioral symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). Mothers completed the questionnaire when their children were four, seven, eight, nine, 11, 13, and 16 years of age. The authors analyzed the children’s polygenic risk score for depression, attention-deficit/hyperactivity disorder, and schizophrenia, all of which have been previously associated with exposure to prenatal adversity.
Among 5,546 mothers and children, the authors found that prenatal maternal depression and anxiety was associated with the child’s internalizing, externalizing, and total emotional symptoms across all ages tested. Children’s total SDQ scores increased by approximately 0.1 points per 1 point increase in the mother’s EPDS score.
Women with elevated prenatal maternal depression (defined as an EPDS score of 13 or greater) or anxiety (defined as a CCEI score of nine or greater) were also more likely to have children with clinically significant mental health symptoms (SDQ score of 14 or greater) at both four and 16 years. This increased risk was independent of such factors as postpartum depression; the risk was also independent of the child’s polygenic risk score.
Sensitivity analyses revealed a significant association between prenatal depression and the child’s mental health, which the authors attributed to the shared genetic risk among the mothers and their children. Shared genetic risk factors accounted for 43% and 46% of the association between prenatal maternal depression and externalizing symptoms among the children at four and 16 years of age, respectively.
“[T]he study results emphasize the need for large-scale interventions to examine the clinical benefits of prenatal interventions on both maternal and child mental health,” the authors concluded.
For related information, see the Psychiatric News article “Treating Family Members Can Break Depression Cycle, Says Expert.”
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