The prospective association of prenatal anxiety symptoms in mothers and fathers with general child development 14 months postpartum and the mediating role of parent-child bonding: a mediation analysis within the longitudinal cohort study DREAM.

BACKGROUND

Anxiety symptoms during pregnancy are a frequent mental health issue for expectant mothers and fathers. Research revealed that prenatal anxiety symptoms can impact parent-child bonding and child development. This study aims to investigate the prospective relationship between prenatal anxiety symptoms and general child development and whether it is mediated by parent-child bonding. Considering the paucity of perinatal research on fathers, their inclusion is of particular interest.

METHODS

Data were derived from the prospective cohort study DREAM including 1,544 mothers and 985 fathers. Anxiety symptoms were assessed during pregnancy; parent-child bonding eight weeks after childbirth; and general child development 14 months postpartum via questionnaires. Mediation analyses were conducted. It was controlled for several perinatal confounding factors in a second model. Postnatal depression symptoms were added to the model as confounding factor in a third step to study its influence separately.

RESULTS

In this population-based sample, prenatal anxiety symptoms were more pronounced in mothers than in fathers, whereas the quality of parent-child bonding was very similar for both parents. No significant association was found between prenatal anxiety symptoms and general child development. But prenatal anxiety symptoms predicted poorer parent-child bonding, also when controlling for confounders (mothers: β =.154; p <.001; fathers: β =.152; p = <.001). However, this effect disappeared when postnatal depression symptoms were additionally controlled for. In turn, parent-child bonding predicted impaired general child development, even when controlling for all confounders (mothers: β = -.104; p =.002; fathers: β = -.104; p =.012). Accordingly, the indirect effect was significant (mothers: β = -.002; BCa 95%CI = [-0.137;0.053]; fathers: β = -.004; BCa 95%CI = [-0.354;0.098]) and therefore parent-child bonding mediated the association between prenatal anxiety symptoms and general child development. However, only when postnatal depression symptoms were not controlled for. These associations did not differ between mothers and fathers.

CONCLUSION

Parent-child bonding is relevant for child development, especially in the presence of prenatal anxiety symptoms. This is the case for both parents, therefore fathers should be included more frequently in perinatal research and clinical practice as their mental health and bonding appear to be equally important. Furthermore, it is important to address parent-child bonding in clinical care, especially when mothers or fathers suffer from anxiety or depression symptoms.