Prenatal depression and child developmental vulnerability.

BACKGROUND

Prenatal depression is a potentially important fetal exposure as it may alter fetal development and have lasting effects.

METHODS

We examined all live births from 2001 to 2012 in British Columbia with follow-up data on the Early Development Instrument (EDI) in Kindergarten. The odds of developmental vulnerability on EDI domains among those with and without depression during pregnancy were estimated. A matched sibling analysis was run using conditional logistic regression within the same birth parent.

RESULTS

We included 130,631 births among 108,340 pregnant people, with 6089 children (4.7%) exposed to prenatal depression. Children exposed to depression during pregnancy were significantly more likely to be considered vulnerable on physical health and well-being (OR, 1.19 [95% CI, 1.10-1.29]), social competence (OR, 1.25 [95% CI, 1.15-1.36]), emotional maturity (OR, 1.18 [95% CI, 1.08-1.28]), language and cognitive development (OR, 1.14 [95% CI, 1.04-1.26]), and multiple domains (OR, 1.18 [95% CI, 1.09-1.27]). No significant associations were found in our matched sibling pair analysis, but effect sizes remained above 1 for physical health and social competences.

CONCLUSION

More research is needed to determine whether fetal exposure to prenatal depression may predispose to childhood vulnerability on physical health and well-being, language and cognition, and socio-emotional domains.

IMPACT

Prenatal depression is common (9-22% of pregnancies) and research has suggested a negative impact on the developing fetal brain but data on long term child development following prenatal depression is sparse. Using a unique population-based dataset with developmental data from children, we found increased risk for developmental vulnerability in physical health and well-being and socio-emotional development. Sibling matched analyses suggested the presence of some residual confounding and associations were no longer statistically significant but effects sizes did not substantially attenuate for physical health and social competence.