Long-term effect of persistent postpartum depression on children's psychological problems in childhood
Hanae Tainaka, Nagahide Takahashi, Tomoko Nishimura, Akemi Okumura, Taeko Harada, Toshiki Iwabuchi, Md. Shafiur Rahman, Yoko Nomura, Kenji J. Tsuchiya
Abstract
BACKGROUND: Maternal postpartum depression (PPD) is a well-established risk factor for psychological problems in children; however, little is known about the sustained impact of persistent PPD patterns and severity on these problems in children. METHODS: Data were obtained from mothers (N = 714) and children (N = 768) from the Hamamatsu Birth Cohort for Mothers and Children. Maternal depression was measured using the Edinburgh Postpartum Depression Scale at 2, 4, 10 weeks and 10 months postpartum. Children's internalizing and externalizing problems were assessed using the Strengths and Difficulties Questionnaire at 6 years and 8-9 years old. Mothers were divided into 4 groups based on the trajectory of their PPD persistence: "No PPD," "Transient PPD," "Worsening PPD" and "Persistent PPD." Linear regression analysis was used to examine the association of PPD persistence and severity with children's internalizing and externalizing problems. RESULTS: "Persistent PPD" was significantly associated with children's internalizing problems at 6 years old (Coefficient [95%CI] = 2.74 [1.30-4.19], P < .001), but no association was found at 8-9 years old. No associations were found between PPD severity and children's internalizing and externalizing problems in either age category. LIMITATIONS: "Persistent PPD" and "Worsening PPD" groups had a relatively small sample size. The mothers' depression statuses were not ascertained simultaneously with the children's behavioral assessments. There was no information regarding the mothers' treatment for PPD. CONCLUSION: PPD persistence negatively affected children's internalizing problems but was not long-lasting. Future studies are needed to identify protective factors against PPD persistence in children's psychological problems.