Deconstructing antenatal depression: What is it that matters for neonatal behavioral functioning?

This prospective study examined the variability within clinical characteristics of antenatal maternal depression and cortisol levels for associations with newborn infant behavior using the Neonatal Behavioral Assessment Scale (NBAS; T.B. Brazelton, 1984). Participants were 81 pregnant women at risk for perinatal depression given their histories of depression prior to pregnancy. We took into consideration not only whether the woman experienced antenatal depression but also whether the depression met diagnostic criteria and variability in timing (onset and occurrence) of antenatal depression and symptom severity. Infants of mothers who became depressed during pregnancy scored less optimally on a subset of the NBAS scales, specifically those scales related to infant neuroregulation. Among the clinical characteristics of depression, the fetus' overall exposure to mothers' depression (reflected in the mean) was most often and most strongly associated with NBAS scales. In terms of timing, third-trimester exposure was significantly related to newborn behavior. The findings are discussed within the S.H. Goodman and I.H. Gotlib (1999) model for transmission of psychopathology to offspring of depressed mothers.