ARTICLES
Antenatal Anxiety Predicts Child Behavioral/Emotional Problems Independently of Postnatal Depression

https://doi.org/10.1097/00004583-200212000-00019Get rights and content

ABSTRACT

Objective:

To examine the hypothesis that the effects of postnatal depression on children's behavioral/emotional problems are explained by antenatal maternal mood.

Method:

The current study investigated this hypothesis in the Avon Longitudinal Study of Parents and Children, a prospective, community-based study that has followed a cohort of women since pregnancy (n = 7,144) who delivered their baby between April 1, 1991, and December 31, 1992. Self-report measures of maternal anxiety and depression were assessed at repeated intervals in pregnancy and the postnatal period. Children's behavioral/emotional problems were assessed by parent report at age 4 years.

Results:

After controlling for smoking, alcohol use, birth weight for gestational age, maternal age, child sex, and socioeconomic status, postnatal depression at 8 weeks (OR = 2.27 [1.55–3.31]) and 8 months (OR = 1.68 [1.12–2.54]) was associated with children's behavioral/emotional problems. Subsequent analyses that included antenatal maternal mood indicated that antenatal anxiety in late pregnancy and not antenatal depression was also independently associated with behavioral/emotional problems at age 4 (OR = 1.72 [1.14–2.59]); 8 week postnatal depression remained a significant predictor after antenatal maternal mood was statistically controlled for (OR = 1.56 [1.04–2.32]).

Conclusions:

Antenatal anxiety and postnatal depression represent separate risks for behavioral/emotional problems in children and act in an additive manner.

Section snippets

Sample and Procedure

The study is based on the ALSPAC, a longitudinal, prospective study of women, their partners, and an index child (Golding et al., 2001). The study design included all pregnant women living in the geographical area of Avon, England, who were to deliver their baby between April 1, 1991, and December 31, 1992. It was estimated that 85% to 90% of the eligible population took part. The average age of the women at pregnancy was 28 years (range 14–46 years). Approximately 45% of the women were

Preliminary Analyses

Attrition analyses are presented in relation to the response rate on the depression data. A total of 10,928 women provided depression data on at least one of the four occasions (i.e., two antenatal and two postnatal; this represents 84% of the sample on whom any data were available). Of these 10,928 women, complete depression data were available for 7,442 women (68%); an additional 2,225 women (20%) provided data on three occasions, 1,080 women (10%) on two occasions, and 180 women (2%)

DISCUSSION

Recent research interest in the effects of postnatal depression on children's development has focused on how distinct features of the depression—notably chronicity, severity, duration, and timing—moderate its effects on children (Brennan et al., 2000;Essex et al., 2001;Murray et al., 1996). A separate strand of studies examines how maternal depression intersects with the caregiving environment to explain variation in children's outcomes (Murray and Cooper, 1997). Findings from the

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    ALSPAC is funded by The Wellcome Trust, the Department of Health, the Department of the Environment, and the Medical Research Council, among many others. Support for this analysis was provided by the PPP Healthcare Medical Trust. The ALSPAC study is part of the WHO-initiated European Longitudinal Study of Pregnancy and Childhood. The authors are grateful to all of the mothers who took part and to the midwives for their cooperation and help in recruitment. The whole ALSPAC study team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers, and managers who continue to make the study possible. The authors thank Drs. Jean Golding and Sherryl Goodman for their comments.

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