Abstract
Introduction Preterm birth has been linked with postpartum depressive (PPD) disorders and high symptoms levels, but evidence remains conflicting and limited in quality. It remains unclear whether PPD symptoms of mothers with preterm babies were already elevated before childbirth, and whether PPD symptoms mediate/aggravate the effect of preterm birth on child mental disorders. We examined whether preterm birth associated with maternal PPD symptoms, depressive symptoms trajectories from antenatal to postpartum stage, and whether PPD symptoms mediated/aggravated associations between preterm birth and child mental disorders. Methods Mothers of preterm(n=125) and term-born(n=3033) children of the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction study reported depressive symptoms four times within 8 weeks before and twice within 12 months after childbirth. Child mental and behavioral disorder diagnoses until age 8.4-12.8 years came from medical register. ResultsPreterm birth associated with higher PPD symptoms(MD=0.19 SD,95%CI 0.01,0.37,p=0.04), and higher odds(OR=2.23,95%CI 1.22,4.09,p=0.009) of the mother to belong to a group that had consistently high depressive symptoms levels trajectory from antenatal to postpartum stage. PPD symptoms partially mediated and aggravated the association between preterm birth and child mental disorders. ConclusionsPreterm birth, maternal PPD symptoms and child mental disorders are associated, calling for timely prevention interventions.
Preterm Birth, Maternal Postpartum Depressive Symptoms and Mental and Behavioral Disorders in Children