Pregnancy Depression Linked to Child Behavioral Issues

A recent study by the University of California Los Angeles (UCLA) points to a mother’s mood and fluctuations in depression pre-conception, during pregnancy, and post-partum affecting a child’s behavior and emotional well-being. 

The UCLA study took place over seven years and analyzed data on 362 pregnant women. Most of the women in the study were Hispanic or Black, and all of the women came from low-income families. Every woman in the study already had one young child at home. 

The main focus of the study was to analyze disparities in available health care and mental health for low-income and minority families. But the findings that women (who were prone to depression before and during pregnancy or who experienced postpartum depression) also had children who experienced more behavioral and emotional problems during early childhood are not new. 

The main takeaway from the UCLA study is that mothers with consistent levels of depression did not have children who experienced behavioral problems; it was the children whose mother’s levels of depression varied. Therefore, this article examines the link between maternal depression and child behavioral issues.

In order to do this, we first need to understand the causes and risk factors of maternal depression.

What is Maternal Depression 

According to the New York State Department of Health, Maternal Depression is categorized as prenatal depression, “Baby Blues,” and postpartum depression.

Prenatal depression affects 10-20% of pregnant women and is characterized by fatigue, sleep problems, crying, appetite loss, anxiety, loss of enjoyment in preferred activities, poor fetal attachment, and irritability. 

The Baby Blues can affect as many as 80% of new mothers and usually begins the first few days after delivery and subsides by the end of week two. Symptoms of the Baby Blues include sadness and crying, irritability, anxiety, frustration, an exaggerated sense of empathy, mood swings, insomnia, and feeling overwhelmed. 

Postpartum Depression affects 10-20% of new mothers and refers to the onset of depression anytime after the birth of the baby that lasts more than two weeks. Postpartum depression includes all the symptoms of prenatal depression and baby blues. It may also include difficulty remembering things and poor concentration, feelings of worthlessness or guilt, loss of interest in caring for oneself, psychomotor agitation or retardation, poor bonding with the baby, headaches, heart palpitations, numbness, hyperventilation, decreased or nonexistent sex drive, and thoughts of death or suicide. 

A rare condition called Postpartum Psychosis affects 1-2% of new mothers, starting anywhere from 2-3 days to two weeks after birth. Symptoms include anxiety, insomnia, hopelessness, auditory and visual hallucinations, paranoia, confusion, delirium, mania, delusions that convince them to harm the baby, and suicidal or homicidal thoughts.

If you or a loved one is experiencing depression, it is essential to seek treatment from a healthcare professional. In addition, if you or a loved one is displaying symptoms of postpartum psychosis, it is considered a medical emergency and requires immediate attention from a health professional. 

Risk Factors for Maternal Depression 

Approximately 14.5% of women will experience postpartum depression within three months of giving birth, according to data from the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS). 

The most common risk factors for maternal depression include:

• A personal or family history of depression, anxiety disorder, or other mood disorders, including prenatal or postpartum depression;
• A current or past history of alcohol or other substance abuse;
• An unplanned or unwanted pregnancy;
• Having a difficult experience with pregnancy or delivery, including preterm birth, multiple births, miscarriage or stillbirth, congenital disabilities or disabilities, or other pregnancy complications;
• Being Caucasian and non-Hispanic ethnicity;
• Being under 24 when giving birth;
• Having a lower maternal socioeconomic status;
• Experiencing stress or relationship problems with the baby’s father;
• A lack of social support or absence of a community network.

While these are the most common risk factors, women with none of these factors in place can still experience prenatal or postpartum depression.

Effects of Maternal Depression on the Child 

When a mother is experiencing depression, it doesn't just affect her; it affects her partner and her child’s health. Children of mothers who experience long-lasting or major depression are at a higher risk for:

• Delays in social, emotional, and cognitive development;
• Long-term mental health problems;
• Missing routine and preventative doctor appointments and more frequent visits to emergency health care;
• Lack of breastfeeding or weaning very early. 

Low maternal mental health impacts the family's overall functioning and increases the chance of paternal depression co-occurring. 

A 2020 study published by the American Academy of Pediatrics showed that maternal depressive symptoms that developed and persisted before a child was five years old had a 17% higher chance of having a developmental delay than their peers not exposed to maternal depression in the postpartum period. 

An additional study also published in 2020 indicated that mothers who suffered depression were more likely to notice significant social-emotional delays in their children by two-and-a-half.

Maternal Depression and Social-Emotional Delays in Children 

Maternal depression seems to have a solid link to a child’s self-image and image of their mother or females. A 2019 study discovered that children whose mothers were depressed were more likely to be self-critical, have lower self-esteem, and be more critical of others. The study also revealed that the children of depressed mothers were less likely to view their mothers positively and as a source of support.

Low self-esteem also correlates to social and emotional difficulties and trouble in school both behaviorally and academically and makes an individual more likely to engage in risky behaviors. 

Negative self-talk is a trait children pick up from adults around them. Children, by nature, mimic what they see and hear, so if a mother is consistently berating herself or her child due to her depression, the child will remember this behavior when interacting with others.

Health Risks 

A mother suffering from depression is statistically less likely to breastfeed. In addition to providing vital nutrients to the baby, breastfeeding reduces the risk of asthma, obesity, Type 2 diabetes, ear and respiratory infections, and sudden infant unexpected death syndrome (SIUDS).

The skin-to-skin contact that occurs during breastfeeding is also vital to forming a strong attachment between mother and child. Therefore, mothers who cannot breastfeed and fathers are encouraged to have regular skin-to-skin contact with their babies to support emotional development. 

Additionally, children of depressed mothers are less likely to attend routine doctor visits, which may result in missed immunizations and the inability to implement early interventions for physical, speech, or cognitive delays. 

Paternal Depression 

It is also worth noting that 4-13% of new fathers experience depression within the first year of their child’s life. Men are most likely to develop perinatal depression in the first one to three months post birth. Like a mother experiencing depression, fathers who experience postpartum depression are less likely to have a positive relationship with their child. 

Symptoms of depression in fathers include traditional depressive disorder symptoms. They may also include a negative or critical outlook toward their partner, anxiety, substance abuse or other numbing behaviors, anger, and irritability. Similarly, paternal depression also impacts the child’s development. 

Combating Child Delays Due to Maternal Depression 

While battling depression can be challenging, there are ways to mitigate developmental delays that may have resulted before a mother could seek or obtain help.

Early intervention is the most successful way to combat developmental delays in a young child. Some treatments focus solely on mother-child activities that moms can do with their babies or toddlers. Anything encouraging physical touch between a mother and her child helps solidify their bond and increases positive attachment.

Other treatments involve talk and play therapy, parenting classes, music, massage therapy, and other activities that engage the senses and encourage interaction between mother and child. 

Early intervention can also be used within the preschool or school system to aid a child who may be struggling emotionally or academically. 

What Causes Depression? 

Mothers and fathers experiencing postnatal depression must not blame themselves or their partners. Depression is not a person’s fault; it does not make someone a bad parent. While the exact cause of depression is unknown, several different factors and life events could factor into an individual developing a major depressive disorder.

Biological differences

People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.

Brain chemistry

Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Therefore, changes in the function and effect of these neurotransmitters may play a role in depression and its treatment. However, a recent study found that there is little evidence that chemical imbalances cause depression. 

Hormones

Depression may involve changes in the body's balance of hormones like cortisol in causing, triggering, or lessening depression. Hormone changes can occur antenatal or during the weeks or months after delivery (postpartum) and from thyroid problems, menopause, or many other conditions.

Inherited traits

Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

Treatment for Depression 

An individual’s treatment plan for depression will vary based on numerous factors. However, it often includes talk therapy and a systematic review of a person’s mental and physical health history. In addition, you will likely be asked to complete a questionnaire rating how often you experience certain feelings or thoughts and on what scale.

Many people are prescribed antidepressants by a psychiatrist or their family doctor in conjunction with therapy. Antidepressants take many forms, but Serotonin Reuptake Inhibitors (SSRIs) are the most common. SSRIs include well-known drugs like Prozac, Lexapro, Celexa, and Zoloft. 

Diet, exercise and physical activity, adequate sleep, and natural stress relieving activities like taking a bath, reading, and listening to music can also help someone who is battling depression.

Prenatal & Postpartum Depression Resources 

• Help.org - Postpartum Depression | Help.org
• Healthline  How to Deal with Postpartum Depression: Diet, Exercise, and More (healthline.com)
• Office of Women’s Health - Postpartum depression | Office on Women's Health (womenshealth.gov)
• Next Avenue - How to Help a Mom Through Postpartum Depression (nextavenue.org)
• American Pregnancy.org  - How to Prevent Postpartum Depression | American Pregnancy Association
• Postpartum Support International - Help for Moms | Postpartum Support International (PSI)
• Today’s Parent - 6 ways to support a mother who has postpartum depression (todaysparent.com)