The Influence of Maternal Postnatal Depressive and Prenatal Anxious and Depressive Symptoms on Children’s Behavioral Problems at Age 3

Abstract

Postnatal depression (PND) is a common mental health condition affecting up to 20% of mothers and has been linked to adverse developmental outcomes in children, including behavioral problems. While previous studies have established an association between PND and child behavior, less is known about whether maternal mental health during pregnancy or child’s sex influences this relationship. This study investigated the association between maternal PND symptoms and behavioral problems in three-year-old children and examined whether prenatal anxious and depressive symptoms moderate this relationship. In addition, it was investigated whether child’s sex moderates the relationship between maternal PND symptoms and child behavioral problems. The sample consisted of 593 mothers and their children from the YOUth Baby and Child cohort, a large population-based longitudinal study in the Netherlands. Maternal PND symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) around 5 months after birth, prenatal anxious/depressive symptoms with the Adult Self Report (ASR) around 20 weeks of pregnancy, and child behavioral problems with the Child Behavior Checklist (CBCL 1.5-5yr) around the age of 3. Linear and moderated regression analyses were performed. Results showed that higher maternal PND symptoms were significantly associated with more behavioral problems in children (B = 1.427, t = 8.202, p < .001). Prenatal anxious/depressive symptoms independently predicted behavioral problems (β = .287, t = 4.007, p < .001), but did not moderate the association between postnatal symptoms and child behavior (β = -.065, t = -0.747, p = .455). The child’s sex did not moderate the relationship between maternal PND symptoms and child behavioral problems at age 3 (β = -0.027, t = -0.384, p = .701). Taken together, both PND symptoms and prenatal anxious/depressive symptoms were associated with more behavioral problems in children, whereas no moderating effects of prenatal symptoms or child’s sex were found. This suggests that higher levels of PND symptoms or prenatal anxious/depressive symptoms are each linked to increased behavioral problems in three-year-old children, regardless of the child’s sex or combined effects of symptoms across periods. These findings highlight the independent effects of prenatal and postnatal mental health on child behavioral problems and emphasize the importance of comprehensive perinatal care.