A bioecological longitudinal study of depressive symptoms from pregnancy to 36 months postpartum.

PURPOSE: Depressive symptoms during the perinatal period have broad and enduring health implications for birthing parents and their offspring. Rising prevalence rates of perinatal depression highlight the need for research examining factors influencing depressive symptoms during pregnancy, and trajectories during the early postnatal period. Grounded in bioecological systems theory, this longitudinal multimethod study examined whether prenatal bioecological factors predict depressive symptoms from pregnancy to 36 months postpartum. METHODS: Participants were 162 pregnant individuals, oversampled for high emotion dysregulation, who completed a life stress interview and physiological assessment during the 3rd trimester and a self-report measure of depression at five time-points (3rd trimester, within 48 h of birth, 7, 18, and 36 months postpartum). Multilevel models were used to test study aims. RESULTS: Participants exhibited the highest levels of depressive symptoms at 3rd trimester, and substantial variability in depressive symptom trajectories over time. Lower resting respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, in the 3rd trimester was associated with higher concurrent depressive symptoms. Higher levels of stress related to partner relationships, finances, and health were concurrently associated with more depressive symptoms during pregnancy and decreases in depressive symptoms over time. Specifically, depressive symptoms decreased only for individuals who reported high levels of stress during pregnancy. LIMITATIONS: Although grounded in bioecological systems theory, this study did not assess the macrosystem. CONCLUSIONS: Results of this study underscore the importance of multilevel predictors of perinatal health and highlights potential targets for preventing depression and promoting well-being during the perinatal transition.

Examining implications of the developmental timing of maternal trauma for prenatal and newborn outcomes.

Separate literatures have demonstrated that mothers' experiences with trauma during childhood or pregnancy are associated with maternal prenatal health risks, adverse childbirth outcomes, and offspring internalizing and externalizing disorders. These literatures largely align with the intergenerational transmission or fetal programming frameworks, respectively. However, few studies have tested the effects of maternal childhood and prenatal trauma simultaneously on mothers' and infants' health outcomes, and no studies have examined these effects on newborn neurobehavioral outcomes. Thus, in the present study, we examined how the developmental timing of pregnant women's traumatic life experiences associated with their physical health and psychopathology (Aim 1) as well as their newborns' birth and neurodevelopmental outcomes (Aim 2; for pre-registered aims and hypotheses, see https://osf.io/ygnre/?view_only=cbe17d0ac7f24af5a4d3e37e24eebead). One hundred and fifty-two 3rd trimester pregnant women (Mage = 29 years; 17.1% Hispanic/Latina) completed measures of trauma history and psychopathology. Then, 24-48 h after birth, trained clinicians conducted newborn neurobehavioral exams (n = 118 newborns; 52.6% female). Results indicated that lifetime traumatic experiences associated with multiple prenatal maternal health outcomes, including depression, anxiety, emotion dysregulation, and pregnancy complications. Pregnant women's experiences with childhood trauma, but not adulthood or prenatal trauma, predicted higher neurobehavioral attention scores among female newborns. Our discussion highlights the importance of considering the developmental timing of maternal trauma on perinatal outcomes and contextualizes our findings within the intergenerational transmission and fetal programming literatures. DATA AVAILABILITY: Data pertaining to R01MH119070 (MPIs Crowell & Conradt) and that support these findings are uploaded to the NIMH repository.