Maternal prenatal mood and pregnancy-specific worries: impact on early child psychopathology

According to a new study in the Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP), specific interventions may be needed in pregnancy to promote early offspring psychopathology health and wellbeing.

Few studies have attempted to identify how distinct dimensions of maternal prenatal affective symptoms relate to offspring psychopathology. As a result, researchers conducted this study to identify whether certain dimensions of prenatal maternal affective symptoms affected offspring psychopathology at 4 to 8 years of age.

The study analyzed data from three separate cohorts of the DREAM-BIG consortium, all with different measures of assessment: Avon Longitudinal Study of Parents and Children (ALSPAC) [N=12,515], Generation R (N=6,803), and the Canadian prenatal cohort Maternal Adversity, Vulnerability, and Neurodevelopment (MAVAN) [N=578].

Using confirmatory factor analyses, the researchers determined whether comparable latent dimensions of prenatal maternal affective symptoms existed across the cohorts. They used structural equation models to examine cohort-specific associations between these dimensions and offspring psychopathology at 4 to 8 years of age.

In all of the cohorts, four prenatal maternal factors were identified as similar: general affective symptoms factor and anxiety/depression, somatic symptoms, and pregnancy-specific worries. The results indicated that general prenatal affective symptoms were associated with general offspring psychopathology, and the authors noted that they were “further associated with children’s specific internalizing, but not externalizing, behavior.”¹

Researchers found that prenatal affective symptoms and pregnancy-specific worries predicted their children’s general psychology at ages 4 to 8 years. These associations remained after controlling for additional cofounders, such as maternal prenatal smoking and alcohol consumption and offspring birthweight, which has been documented in previous research.

“Consequently, as casual mechanisms are not yet fully understood, one should exercise caution when adjusting for variables that might be part of the casual pathway in order to avoid over adjustment.”¹

Through this study, the researchers were able to identify a latent structure of prenatal affective problems that could be generalized across multiple cohorts. This bifactor model included a “general factor” encompassing variance common to all depressive, anxiety, and pregnancy-specific symptoms.

The existence of a general factor such as this has been previously supported for postnatal maternal affective symptoms using only the Edinburgh Postnatal Depression Scale (EPDS) and additional studies that analyze a bifactor structure do not exist.

As previous literature suggests, the results of this study show that pregnancy anxiety and general prenatal anxiety/depression are only moderately associated. This study, however, shows a method in which we can study the independent and overlapping effects simultaneously. 

Future research could benefit from a similar model and study design demonstrated here and would allow for close monitoring of offspring impact.

References:

1. Szekely E, Neumann A, Sallis H, et al. Maternal Prenatal Mood, Pregnancy-Specific Worries, and Early Child Psychopathology: Findings From the DREAM BIG Consortium [published online ahead of print, 2020 Apr 7]. J Am Acad Child Adolesc Psychiatry. 2020;S0890-8567(20)30164-7. doi:10.1016/j.jaac.2020.02.017