Opening windows of opportunities: Evidence for interventions to prevent or treat depression in pregnant women being associated with changes in offspring's developmental trajectories of psychopathology risk.

Although animal models and correlational studies support a model of fetal programming as a mechanism in the transmission of risk for psychopathology from parents to children, the experimental studies that are required to empirically test the model with the human prenatal dyad are scarce. With a systematic review and meta-analysis of the literature, we critically examined the evidence regarding the neurobiological and behavioral changes in infants as a function of randomized clinical trials to prevent or reduce maternal depression during pregnancy, treating randomized clinical trials as experiments testing the fetal programming model. Based on 25 articles that met inclusion criteria, we found support for interventions designed to change maternal prenatal mood being associated with changes in offspring functioning, but with a very small effect size. Effect sizes ranged broadly, and were higher for younger children. The findings enhance understanding of putative mechanisms in the transmission of risk from women's prenatal depression to infants' vulnerabilities to, and early signs of, the development of psychopathology. We note limitations of the literature and suggest solutions to advance understanding of how preventing or treating depression in pregnant women might disrupt the transmission of risk to the infants.

Satisfaction with parental responsibilities and disorganized attachment among infants of mothers at risk for depression.

Growing attention has been placed on examining the family environment as antecedent of attachment, including the coparenting relationship. Parents' satisfaction with the coparenting relationship may be particularly of interest when parents are at heightened risk for depression, as depression has been consistently linked to negative coparenting, poor quality of parenting, and insecure infant attachment. However, no study has examined the effects of parents' satisfaction with the coparenting relationship on attachment. The present study examined mothers' satisfaction with division of childrearing responsibilities, a component of coparenting, and its longitudinal and cross-sectional links with infant disorganized attachment, examining the quality of mothering as a mediator, in a sample of infants and mothers at elevated risk for depression (N = 234). We assessed maternal depressive symptoms at 3, 6, and 12 months of infant age, mothers' satisfaction with the division of parental responsibilities at 3 and 12 months, the quality of mothering at 6 and 12 months, and infant disorganized attachment at 12 months. Mediation analyses revealed that at 12 months, mothers who were unsatisfied with fathers' childrearing responsibilities had poorer quality of mothering, which in turn was linked to disorganized attachment in their infants. However, the longitudinal indirect association between satisfaction with childrearing responsibilities at 3 months and disorganization at 12 months mediated by maternal parenting at 6 months was not significant. Findings emphasize the importance of partner support in childrearing for mothers at risk for depression in shaping a healthy relationship between mothers and their infants, particularly as infants get older. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Associations Between Breastfeeding, Maternal Emotional Availability, and Infant-Mother Attachment: The Role of Coparenting.

BACKGROUND: Breastfeeding is a parenting practice that combines close intimate contact with the opportunity to be sensitive and responsive to the infant, and may have direct and indirect relations with infant attachment. However, researchers have produced inconsistent findings, suggesting there may be other mechanisms involved. Coparenting may play a significant role, as it has been consistently associated with mother-infant relationships. RESEARCH AIMS: The aims of this study were to examine: (1) whether breastfeeding would be directly associated with infant-mother attachment; (2) whether this association was also indirect, through mothers' quality of caregiving; and (3) whether partners' coparenting support moderates breastfeeding's indirect association with attachment. METHODS: This was a prospective, longitudinal study that drew data from a larger NIH-funded study on sleep and family relationships (R01HD052809). Mothers reported on their feeding practices and coparenting relationships. Independent observations were used to assess mothers' emotional availability toward infants. A separate team of observers assessed infant-mother attachment. RESULTS: Exclusive breastfeeding during the first 6 months, and longer duration of any breastfeeding across the 1st year, were directly associated with more secure infant-mother attachment. These associations were also indirect, through maternal emotional availability. Coparenting was a significant moderator, such that the influence of longer breastfeeding duration on improved emotional availability, and, in turn, on more secure attachment, was significant only for mothers who perceived coparenting quality to be low. CONCLUSION: Findings highlighted the importance of breastfeeding on both the quality of mothering and infant attachment, but also emphasized that coparenting support may be particularly important for mothers who are unable to breastfeed.

Unique Characteristics of Women and Infants Moderate the Association between Depression and Mother-Infant Interaction.

Research has shown mixed results regarding the association between women's postpartum depression and mother-infant interactions, suggesting that a woman's unique experience and context may moderate how depression shapes these interactions. We examined the extent to which a woman's comorbid anxiety, her exposure to adversity, and infant characteristics moderate the relationship between depressive symptoms of women and interactions with their infants at 6 (n = 647) and 12 months (n = 346) postpartum. The methods included standardized coding of mother-infant interactions and structural regression modeling. The results at 6 months of infant age indicated that infant male sex and infant negative affectivity were risk factors for mothers' depression being associated with less optimal interactions. At 12 months of infant age, two moderators appeared to buffer the influence of depression: a woman's history of trauma and infant preterm birth (≤37 weeks gestation). The results reinforce the salience of infant characteristics in the relationship between maternal depression and mother-infant interactions. The findings also suggest that experiences of trauma may offer opportunities for psychological growth that foster constructive management of depression's potential effect on mother-infant interactions. Further research is needed to clarify the underlying processes and mechanisms that explain the influence of these moderators. The ultimate goals are to reduce the risk of suboptimal interactions and reinforce healthy dyadic relations.

Maternal nighttime sleep and infant-mother attachment security: The mediating role of maternal parenting quality during bedtime and free play.

The present study examined mothers' emotional availability (EA) during daytime free play and bedtime as a mediator of linkages between maternal nighttime sleep and infant-mother attachment. Participants included 153 mothers (85% White) with infants (53% female). When infants were 1, 3, 6, 9, and 12 months, maternal sleep was assessed using actigraphy and daily sleep diaries for 7 consecutive days. At each time point, mothers' EA was scored from one observation of daytime free play and from one evening observation of infant bedtime by trained observers who were blind to all other participant information. Average scores were created for maternal sleep and EA across the five occasions in the first year. At 12 and 18 months, infant-mother attachment security in the home was scored by blind observers using the Attachment Q-Set, averaged across the two age points, and used in analyses. Mediational analyses revealed that mothers who experienced highly variable sleep and had poor sleep quality were less emotionally available with infants at bedtime during infants' first year of life, which in turn was predictive of lower infant-mother attachment security in the second year, supporting mediation. Linkages between maternal sleep characteristics and daytime EA were less evident. Later maternal sleep timing was also directly predictive of low attachment security, after accounting for maternal EA. Findings emphasize that poor parental sleep places both parenting and infant socioemotional development at risk, and that parental sleep hygiene and sleep habits should be a salient focus of parenting intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Quality of coparenting and infant-mother attachment: The mediating role of maternal emotional availability.

Increasing attention has been paid to the influence of family contextual factors in predicting infant attachment security. However, little is known about the influence of coparenting quality on attachment. The goal of the present study was to examine the associations among parental perceptions of coparenting quality, quality of mothering (as indexed by maternal emotional availability), and infant-mother attachment. Parental reports of positive and negative coparenting quality, maternal emotional availability, and infant-mother attachment were assessed in 152 infants and their parents at 1, 3, 6, 9, and 12 months postpartum. Direct and indirect effects were assessed within a structural equation modeling framework to examine: (a) direct effects of mother-reported coparenting on infant-mother attachment, (b) indirect effects of mother-reported coparenting on infant-mother attachment through maternal emotional availability, and (c) indirect effects of father-reported coparenting on infant-mother attachment through maternal emotional availability. Results indicated that there was an indirect, but not direct, association between mother-reported coparenting quality across the first year of life and infant-mother attachment at 1 year through maternal emotional availability across the first year. Father-reported coparenting across infants' first year was not associated with infant-mother attachment at 1 year. Post hoc analyses revealed that mothers' perceptions of coparenting at 1 month were indirectly linked to attachment at 1 year through maternal emotional availability across the first year. Findings highlight the importance of coparenting quality, especially in the early postpartum, in organizing quality of parenting and infant attachment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Correction to: Parenting as a Mediator of Associations between Depression in Mothers and Children's Functioning: A Systematic Review and Meta-Analysis.

The original version of the article requires a correction to one of the sentences. Under the section 'Limitations', the last sentence 'Findings of no support for mediation was also deemed important as, for example, our findings suggest..' should read as below. Also important were where we found no support for moderation of the mediation model; for example, our findings suggest that parenting as a mediator of associations between depression and child functioning is concerning regardless of the ages of the children, for both sons and daughters, and for a broad range of aspects of children's functioning.

Parenting as a Mediator of Associations between Depression in Mothers and Children's Functioning: A Systematic Review and Meta-Analysis.

This paper responds to the need to understand mechanisms in the pathways of risk from depression in mothers to their children's functioning. We systematically reviewed evidence in support of one often-proposed mediational model: that problematic parenting at least partially explains associations between mothers' depression and children's adverse functioning. We further aimed to understand the conceptual and method-based moderators. Eligible studies had to be published in English in a peer-reviewed journal, include data on mothers' depression and parenting and child functioning, and have a study design whereby measurement of depression in mothers preceded the measurement of parenting, which preceded the measurement of child outcome. Overall, across the 40 papers (37 "studies") that met our inclusion criteria, we found a significant, albeit small effect (r = .016), for the mediational model as a whole. This effect size was robust to context (poverty and ethnicity), children's characteristics of age and gender, and parenting quality (positive or negative). The model was significant for multiple domains of child functioning, although effect sizes varied across domains. We also found support, with small effect sizes, for all three pathways in the mediational model and some support for moderation of those pathways. Overall, the findings provide empirical support for parenting (both positive and negative) as a mediator of associations between mothers' depression and a broad range of child functioning and suggest that interventions should target samples that represent the population in terms of poverty and ethnicity and children's gender, with priority going to interventions targeting the youngest children.