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based on data from a cohort study of more than 50,000 children.
Previous research supports a link between maternal depression and poor cognitive development in children, but the effect of children’s age when exposed to depression on their development has not been well studied, wrote Elizabeth Wall-Wieler, PhD, of Stanford (Calif.) University, and colleagues.
In a population-based cohort study published in Pediatrics, the researchers examined data from 52,103 children born in Manitoba, Canada who completed the Early Development Instrument (EDI) between 2005 and 2016. The EDI is a 103-item questionnaire given to kindergarteners in a classroom setting during the second half of the school year. The EDI is designed to assess five domains: physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge. The researchers assessed maternal depression using a combination of physician visits, hospitalizations, and pharmaceutical data; 19% of the children had a mother diagnosed with depression during the study.
Difficulties emerged in social functioning, emotion regulation
Children whose mothers had a diagnosis of depression before they reached age 5 years had a 1.17 times increased risk of having a problem in one or more of the developmental domains at school entry, compared with those whose mothers had no such diagnosis. Overall, exposure to maternal depression was significantly associated with problems in the areas of social competence (adjusted risk ratio 1.28), physical health and well-being (aRR 1.28), and emotional maturity (aRR 1.27) in kindergarten. For these three domains, children exposed to maternal depression between the ages of 4 and 5 years showed the greatest risk of developmental vulnerability, the researchers said.
“It is noteworthy that these difficulties were reported by the children’s teachers, avoiding negative biases inherent in having mothers with depression serve as informants,” Dr. Wall-Wieler and associates wrote.
The study findings were limited by several factors related to the observational design, including incomplete data on maternal depression prevalence and severity, the researchers said. In addition, the study did not account for confounding variables related to parenting style and information on the presence and psychiatric profiles of fathers.
The results support previous studies by identifying the impact of exposure to maternal depression on particular developmental domains, the researchers concluded. However, more research is needed to extend their findings.
“In particular, investigators should work to elucidate the mechanisms that underlie this intergenerational transmission to young children of mothers with depression at risk for social and emotional difficulties, focusing on aspects of the caregiving environments and behaviors to which these children are exposed,” Dr. Wall-Wieler and associates concluded.
Approximately 70% of the children exposed to maternal depression did not test as vulnerable in any of the developmental domains. Factors that promoted resilience in the children exposed to maternal depression who did not experience developmental vulnerability should be identified, they noted.
Maternal depression is a public health crisis
“The widespread prevalence of maternal depression in the United States and worldwide, with estimates ranging from 3% to 60%, constitutes a public health crisis, particularly one affecting low-income women and their children,” Stephanie Klees Goeglein, MD, and Yvette E. Yatchmink, MD, PhD, of Brown University, Providence, R.I., wrote in an accompanying editorial (Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-010413). The study adds to the research and understanding of the negative impact of maternal depression on child development, but also raises questions because some key confounders were not addressed, mainly “the presence of prenatal depression, severity and chronicity of maternal depression, comorbidities, and parenting practices including the involvement of fathers or partners,” they noted.
Don’t discount the impact of prenatal depression, the editorialists stressed. “Surprising to some, prenatal depression is more common than postpartum depression and may be a major, unexplored contributor to the developmental vulnerability of the children in the sample,” Dr. Goeglein and Dr. Yatchmink said.
However, the fact that approximately 70% of the children exposed to maternal depression did not have developmental vulnerability in any domain is encouraging, and speaks to the resiliency of children to overcome adverse conditions, they added.
Pediatricians can play a role in reducing maternal depression by screening mothers starting at a prenatal visit and continuing through post partum, infancy, and beyond. In addition, actions to improve access to mental health care for mothers and to develop culturally-sensitive positive parenting programs may help reduce the effects of depression on mothers and children, Dr. Goeglein and Dr. Yatchmink emphasized.
Empower depressed mothers to seek assistance
The results were not surprising, but a study that “validates that which we feel we know is clinically significant,” Lillian M. Beard, MD, of Children’s National in Washington, said in an interview.
“This study restates why it is so important for us to evaluate and recognize maternal depression,” she said. “As a busy pediatrician, once I recognize a problem, I struggle with how to provide viable professional and valuable community resources for these mothers.
“My take-home message from the study is that we must screen for maternal depression. When we suspect maternal depression, it is usually present,” Dr. Beard said. “While we cannot change all the factors that contribute to this condition, to help the children we serve to be physically and emotionally sound, we must help empower their mothers to seek assistance, when needed, to be emotionally healthy,” she emphasized.
“More research is needed to recognize the efficacy and value of community-based assistance for maternal and family depression,” said Dr. Beard, who was not involved with the study and was asked to comment on the findings.
The study was supported by the Canadian Institutes of Health Research, the National Institute of Mental Health, and the National Institutes of Health. The researchers and editorialists had no financial conflicts to disclose. Dr. Beard, a member of the Pediatric News editorial advisory board, had no relevant financial disclosures.
SOURCE: Wall-Wieler E et al. Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-0794.
based on data from a cohort study of more than 50,000 children.
Previous research supports a link between maternal depression and poor cognitive development in children, but the effect of children’s age when exposed to depression on their development has not been well studied, wrote Elizabeth Wall-Wieler, PhD, of Stanford (Calif.) University, and colleagues.
In a population-based cohort study published in Pediatrics, the researchers examined data from 52,103 children born in Manitoba, Canada who completed the Early Development Instrument (EDI) between 2005 and 2016. The EDI is a 103-item questionnaire given to kindergarteners in a classroom setting during the second half of the school year. The EDI is designed to assess five domains: physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge. The researchers assessed maternal depression using a combination of physician visits, hospitalizations, and pharmaceutical data; 19% of the children had a mother diagnosed with depression during the study.
Difficulties emerged in social functioning, emotion regulation
Children whose mothers had a diagnosis of depression before they reached age 5 years had a 1.17 times increased risk of having a problem in one or more of the developmental domains at school entry, compared with those whose mothers had no such diagnosis. Overall, exposure to maternal depression was significantly associated with problems in the areas of social competence (adjusted risk ratio 1.28), physical health and well-being (aRR 1.28), and emotional maturity (aRR 1.27) in kindergarten. For these three domains, children exposed to maternal depression between the ages of 4 and 5 years showed the greatest risk of developmental vulnerability, the researchers said.
“It is noteworthy that these difficulties were reported by the children’s teachers, avoiding negative biases inherent in having mothers with depression serve as informants,” Dr. Wall-Wieler and associates wrote.
The study findings were limited by several factors related to the observational design, including incomplete data on maternal depression prevalence and severity, the researchers said. In addition, the study did not account for confounding variables related to parenting style and information on the presence and psychiatric profiles of fathers.
The results support previous studies by identifying the impact of exposure to maternal depression on particular developmental domains, the researchers concluded. However, more research is needed to extend their findings.
“In particular, investigators should work to elucidate the mechanisms that underlie this intergenerational transmission to young children of mothers with depression at risk for social and emotional difficulties, focusing on aspects of the caregiving environments and behaviors to which these children are exposed,” Dr. Wall-Wieler and associates concluded.
Approximately 70% of the children exposed to maternal depression did not test as vulnerable in any of the developmental domains. Factors that promoted resilience in the children exposed to maternal depression who did not experience developmental vulnerability should be identified, they noted.
Maternal depression is a public health crisis
“The widespread prevalence of maternal depression in the United States and worldwide, with estimates ranging from 3% to 60%, constitutes a public health crisis, particularly one affecting low-income women and their children,” Stephanie Klees Goeglein, MD, and Yvette E. Yatchmink, MD, PhD, of Brown University, Providence, R.I., wrote in an accompanying editorial (Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-010413). The study adds to the research and understanding of the negative impact of maternal depression on child development, but also raises questions because some key confounders were not addressed, mainly “the presence of prenatal depression, severity and chronicity of maternal depression, comorbidities, and parenting practices including the involvement of fathers or partners,” they noted.
Don’t discount the impact of prenatal depression, the editorialists stressed. “Surprising to some, prenatal depression is more common than postpartum depression and may be a major, unexplored contributor to the developmental vulnerability of the children in the sample,” Dr. Goeglein and Dr. Yatchmink said.
However, the fact that approximately 70% of the children exposed to maternal depression did not have developmental vulnerability in any domain is encouraging, and speaks to the resiliency of children to overcome adverse conditions, they added.
Pediatricians can play a role in reducing maternal depression by screening mothers starting at a prenatal visit and continuing through post partum, infancy, and beyond. In addition, actions to improve access to mental health care for mothers and to develop culturally-sensitive positive parenting programs may help reduce the effects of depression on mothers and children, Dr. Goeglein and Dr. Yatchmink emphasized.
Empower depressed mothers to seek assistance
The results were not surprising, but a study that “validates that which we feel we know is clinically significant,” Lillian M. Beard, MD, of Children’s National in Washington, said in an interview.
“This study restates why it is so important for us to evaluate and recognize maternal depression,” she said. “As a busy pediatrician, once I recognize a problem, I struggle with how to provide viable professional and valuable community resources for these mothers.
“My take-home message from the study is that we must screen for maternal depression. When we suspect maternal depression, it is usually present,” Dr. Beard said. “While we cannot change all the factors that contribute to this condition, to help the children we serve to be physically and emotionally sound, we must help empower their mothers to seek assistance, when needed, to be emotionally healthy,” she emphasized.
“More research is needed to recognize the efficacy and value of community-based assistance for maternal and family depression,” said Dr. Beard, who was not involved with the study and was asked to comment on the findings.
The study was supported by the Canadian Institutes of Health Research, the National Institute of Mental Health, and the National Institutes of Health. The researchers and editorialists had no financial conflicts to disclose. Dr. Beard, a member of the Pediatric News editorial advisory board, had no relevant financial disclosures.
SOURCE: Wall-Wieler E et al. Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-0794.
based on data from a cohort study of more than 50,000 children.
Previous research supports a link between maternal depression and poor cognitive development in children, but the effect of children’s age when exposed to depression on their development has not been well studied, wrote Elizabeth Wall-Wieler, PhD, of Stanford (Calif.) University, and colleagues.
In a population-based cohort study published in Pediatrics, the researchers examined data from 52,103 children born in Manitoba, Canada who completed the Early Development Instrument (EDI) between 2005 and 2016. The EDI is a 103-item questionnaire given to kindergarteners in a classroom setting during the second half of the school year. The EDI is designed to assess five domains: physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge. The researchers assessed maternal depression using a combination of physician visits, hospitalizations, and pharmaceutical data; 19% of the children had a mother diagnosed with depression during the study.
Difficulties emerged in social functioning, emotion regulation
Children whose mothers had a diagnosis of depression before they reached age 5 years had a 1.17 times increased risk of having a problem in one or more of the developmental domains at school entry, compared with those whose mothers had no such diagnosis. Overall, exposure to maternal depression was significantly associated with problems in the areas of social competence (adjusted risk ratio 1.28), physical health and well-being (aRR 1.28), and emotional maturity (aRR 1.27) in kindergarten. For these three domains, children exposed to maternal depression between the ages of 4 and 5 years showed the greatest risk of developmental vulnerability, the researchers said.
“It is noteworthy that these difficulties were reported by the children’s teachers, avoiding negative biases inherent in having mothers with depression serve as informants,” Dr. Wall-Wieler and associates wrote.
The study findings were limited by several factors related to the observational design, including incomplete data on maternal depression prevalence and severity, the researchers said. In addition, the study did not account for confounding variables related to parenting style and information on the presence and psychiatric profiles of fathers.
The results support previous studies by identifying the impact of exposure to maternal depression on particular developmental domains, the researchers concluded. However, more research is needed to extend their findings.
“In particular, investigators should work to elucidate the mechanisms that underlie this intergenerational transmission to young children of mothers with depression at risk for social and emotional difficulties, focusing on aspects of the caregiving environments and behaviors to which these children are exposed,” Dr. Wall-Wieler and associates concluded.
Approximately 70% of the children exposed to maternal depression did not test as vulnerable in any of the developmental domains. Factors that promoted resilience in the children exposed to maternal depression who did not experience developmental vulnerability should be identified, they noted.
Maternal depression is a public health crisis
“The widespread prevalence of maternal depression in the United States and worldwide, with estimates ranging from 3% to 60%, constitutes a public health crisis, particularly one affecting low-income women and their children,” Stephanie Klees Goeglein, MD, and Yvette E. Yatchmink, MD, PhD, of Brown University, Providence, R.I., wrote in an accompanying editorial (Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-010413). The study adds to the research and understanding of the negative impact of maternal depression on child development, but also raises questions because some key confounders were not addressed, mainly “the presence of prenatal depression, severity and chronicity of maternal depression, comorbidities, and parenting practices including the involvement of fathers or partners,” they noted.
Don’t discount the impact of prenatal depression, the editorialists stressed. “Surprising to some, prenatal depression is more common than postpartum depression and may be a major, unexplored contributor to the developmental vulnerability of the children in the sample,” Dr. Goeglein and Dr. Yatchmink said.
However, the fact that approximately 70% of the children exposed to maternal depression did not have developmental vulnerability in any domain is encouraging, and speaks to the resiliency of children to overcome adverse conditions, they added.
Pediatricians can play a role in reducing maternal depression by screening mothers starting at a prenatal visit and continuing through post partum, infancy, and beyond. In addition, actions to improve access to mental health care for mothers and to develop culturally-sensitive positive parenting programs may help reduce the effects of depression on mothers and children, Dr. Goeglein and Dr. Yatchmink emphasized.
Empower depressed mothers to seek assistance
The results were not surprising, but a study that “validates that which we feel we know is clinically significant,” Lillian M. Beard, MD, of Children’s National in Washington, said in an interview.
“This study restates why it is so important for us to evaluate and recognize maternal depression,” she said. “As a busy pediatrician, once I recognize a problem, I struggle with how to provide viable professional and valuable community resources for these mothers.
“My take-home message from the study is that we must screen for maternal depression. When we suspect maternal depression, it is usually present,” Dr. Beard said. “While we cannot change all the factors that contribute to this condition, to help the children we serve to be physically and emotionally sound, we must help empower their mothers to seek assistance, when needed, to be emotionally healthy,” she emphasized.
“More research is needed to recognize the efficacy and value of community-based assistance for maternal and family depression,” said Dr. Beard, who was not involved with the study and was asked to comment on the findings.
The study was supported by the Canadian Institutes of Health Research, the National Institute of Mental Health, and the National Institutes of Health. The researchers and editorialists had no financial conflicts to disclose. Dr. Beard, a member of the Pediatric News editorial advisory board, had no relevant financial disclosures.
SOURCE: Wall-Wieler E et al. Pediatrics. 2020 Aug 17. doi: 10.1542/peds.2020-0794.
FROM PEDIATRICS