Timing and Trajectories of Maternal Depression during Pregnancy and Emotional Reactivity Outcomes in the Preschool Period Open Access

Swales, Danielle Alexis (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/bz60cw74z?locale=en
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Abstract

Background: The intrauterine environment can have a profound effect on the developing fetus, shaping the developmental trajectory of the child and producing fetal programming effects which may be sustained well into the postnatal period. Prenatal exposure to maternal depression within this sensitive period of development has been linked to a variety of adverse physiological, neurological, and behavioral outcomes across infancy and early childhood. The current study investigated the relationship between the timing and trajectory of maternal depression during pregnancy and emotional reactivity outcomes of the offspring in the preschool period. The sex of the child was also considered as a potential moderator of this relationship.

Methods: 180 mothers were recruited for participation in the study during pregnancy, and they then returned to the laboratory for a follow up visit when the child reached preschool age. Maternal depressive symptoms during pregnancy were measured using self-report. Emotional reactivity was assessed through multiple measures, including cortisol reactivity and laboratory observational measures of emotional reactivity following exposure to a stressor task. Maternal and alternative caregiver report of the child's emotional reactivity were obtained as well.

Results: Growth Mixture Modeling was used to empirically define three trajectory classes of maternal depression during the prenatal period within the sample. A trajectory class representing high but decreasing levels of maternal depression across pregnancy, as well as a separate measure of maternal depression in the first trimester, were found to be significantly and positively related to offspring cortisol reactivity. Maternal depression in the first and second trimester was also found to be positively related to alternative caregiver report of emotional reactivity in girls but not boys. Laboratory observational measures and maternal report of offspring emotional reactivity were not found to be significantly related to maternal depression during pregnancy.

Conclusions: Findings support a link between the timing and trajectory of maternal depression during pregnancy and markers of emotional reactivity in the preschool period. The clinical implications of study findings were considered and future research directions were discussed.

Table of Contents

Introduction 1

Maternal Depression and Emotional Reactivity 2

Effect of Maternal Depression on the Fetal Environment 3

Fetal Programming Hypothesis 5

Impact on Developing Neurological Structures 5

Long Term Emotional Reactivity Outcomes 7

Timing and Trajectory of Maternal Depression 7

Sex Differences 8

The Current Study 9

Methods 10

Participants 10

Procedure 11

Measures 11

Results 16

Discussion 21

Limitations 24

Strengths 24

Clinical Implications 25

Future Research Directions 25

Conclusions 26

References 28

Tables 32

Figures 45

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