Trajectories of maternal depression and offspring psychopathology at 6 years: 2004 pelotas cohort study.


Background: Few studies have addressed the course and severity of maternal depression and its effects on child psychiatric disorders from a longitudinal perspective. This study aimed to identify longitudinal patterns of maternal depression and to evaluate whether distinct depression trajectories predict particular psychiatric disorders in offspring. Methods: Cohort of 4231 births followed-up in the city of Pelotas, Brazil. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) at 3, 12, 24 and 48 months and 6 years after delivery. Psychiatric disorders in 6-year-old children were evaluated through the development and well-being assessment (DAWBA) instrument. Trajectories of maternal depression were calculated using a group-based modelling approach. Results: We identified five trajectories of maternal depressive symptoms: a ‘low’ trajectory (34.8%), a ‘moderate low’ (40.9%), a ‘increasing’ (9.0%), a ‘decreasing’ (9.9%), and a ‘high-chronic’ trajectory (5.4%). The probability of children having any psychiatric disorder, as well as both internalizing and externalizing problems, increased as we moved from the ‘low’ to the ‘high-chronic’ trajectory. These differences were not explained by maternal and child characteristics examined in multivariate analyses. Limitations: Data on maternal depression at 3-months was available on only a sub-sample. In addition, we had to rely on maternal report of child’s behavior alone. Conclusions: The study revealed an additive effect on child outcome of maternal depression over time. We identified a group of mothers with chronic and severe symptoms of depression throughout the first six years of the child life and for this group child psychiatric outcome was particularly compromised.