Depression During Pregnancy Linked to Kids' Behavior Problems

  • by Staff Writer, MedPage Today

Action Points

  • Explain to interested patients that this observational study could not establish a causal relationship between maternal depression during pregnancy and their child's subsequent behavior problems.

Children born to mothers who were depressed during pregnancy were more than twice as likely to display antisocial behavior by age 16 as children whose mothers had not been depressed, researchers found.

Of 120 mothers from South London who were followed from pregnancy through their children's teen years, 31% had depression during pregnancy, according to Dale Hay, PhD, of Cardiff University in Wales, and colleagues.

Children born to these women were significantly more likely to display antisocial behavior (OR 2.46, 95% CI 1.10 to 5.48) and commit violent acts (OR 4.36, 95% CI 1.54 to 12.41) before age 16, the researchers reported in the January/February issue of Child Development.

The associations were magnified in women who also had a history of behavior problems when they were children.

"A focus on mothers' history of conduct problems and depression during pregnancy, as opposed to broader measures of the social environment, would hold promise for more targeted early interventions to prevent the development of serious antisocial behavior," Hay's group wrote.

Previous studies have linked mothers' mental health problems in pregnancy with disruptive behaviors in their children, but it's unclear what explains the relationship, according to the researchers.

To explore the issue, they turned to the South London Child Development Study, which prospectively followed 120 pregnant women and their children into the teenage years.

All families came from a relatively disadvantaged urban area. These families were more likely to belong to the working class and to be from ethnic minority groups than the general U.K. population.

One-third of the children had been arrested or diagnosed with a conduct disorder by age 16. Of these 88.9% had been arrested and 45% had committed violent acts, including theft from a person, violent disorder, fighting, carrying a weapon, and assault.

The association between maternal depression during pregnancy and risk of antisocial behavior remained relatively constant in analyses controlling for family environment, a child's exposure to maternal depression after birth, mothers' substance use during pregnancy, and parental antisocial behavior.

None of the factors fully explained the relationship. Neither did the arrest history of the biological father.

But, the researchers wrote in the paper, "it would be unwise to conclude that paternal risk factors are unimportant, given that we did not have more detailed information about the father's own history of conduct disorders."

They explored several potential mechanisms for the link between maternal depression and a child's behavior problems:

  • Direct effects on the fetus from biological correlates of the mothers' depressive symptoms
  • Depression in pregnancy as a sign of environmental adversity
  • Re-exposure to maternal depression after birth
  • Indirect effects of depression on the developing fetus driven by mothers' smoking, drinking, and drug taking during pregnancy
  • A genetic explanation whereby women who experience depression in pregnancy may also have a greater genetic risk for antisocial behavior, which they pass on to their offspring

Hay and her colleagues noted that these explanations are not necessarily mutually exclusive.

They also acknowledged some limitations of the study, including the lack of information about fetal growth and neuroendocrine measures on the mother and child and the relatively small sample size.

The SLCDS has been funded by U.K. project grants from the Medical Research Council, by the Psychiatric Research Trust, and by the South West G.P. Trust. The current analysis was partially supported by an Economic and Social Research Council studentship to one of Hay's co-authors and by a Medical Research Council U.K. Program Grant.

The authors did not report any conflicts of interest.
