From the Journals

Maternal depression may derail children’s school readiness



Children exposed to maternal depression before 5 years of age were 1.17 more likely to experience developmental problems at school entry than were those not exposed, based on data from a cohort study of more than 50,000 children.

A worried woman holds a young boy while looking through a window Juanmonino/Getty Images

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.


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