Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross‐cohort consistency study

Background: Maternal depression and anxiety during pregnancy have been associated with offspring‐attention deficit problems. Aim: We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross‐cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. Methods: This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant women and their partners completed questionnaires to assess symptoms of depression and anxiety. Child attention problems were measured in Generation R at age 3 with the Child Behavior Checklist, and in ALSPAC at age 4 with the Strengths and Difficulties Questionnaire. Results: In both cohorts, antenatal maternal symptoms of depression (Generation R: OR 1.23, 95% CI 1.05–1.43; ALSPAC: OR 1.33, 95% CI 1.19–1.48) and anxiety (Generation R: OR 1.24, 95% CI 1.06–1.46; ALSPAC: OR 1.32, 95% CI 1.19–1.47) were associated with a higher risk of child attention problems. In ALSPAC, paternal depression was also associated with a higher risk of child attention problems (OR 1.11, 95% CI 1.00–1.24). After adjusting for maternal symptoms after giving birth, antenatal maternal depression and anxiety were no longer associated with child attention problems in Generation R. Moreover, there was little statistical evidence that antenatal maternal and paternal depression and anxiety had a substantially different effect on attention problems of the child. Conclusions: The apparent intrauterine effect of maternal depression and anxiety on offspring‐behavioural problems may be partly explained by residual confounding. There was little evidence of a difference between the strength of associations of maternal and paternal symptoms during pregnancy with offspring‐attention problems. That maternal symptoms after childbirth were also associated with offspring‐behavioural problems may indicate a contribution of genetic influences to the association.     

ADHD deficit as measured in adolescent boys with a continuous performance task is related to antenatal maternal anxiety

Antenatal maternal anxiety has been shown to be related to infant temperament, childhood disorders, and impulsivity in adolescence. This study prospectively investigated whether antenatal maternal anxiety is associated with performance on a continuous performance task. Sixty-four adolescents (mean age, 15 y; 34 boys, 30 girls) were examined with a computerized continuous performance task (CPT) measuring sustained attention. Results showed that the CPT performance of boys of mothers with high levels of state anxiety during the 12th to 22nd postmenstrual week of pregnancy declined as the task progressed: their processing speed became slower and the variability in their reaction times increased. The study controlled for the possible confounding influences of postnatal maternal anxiety, the parents' educational level, and intelligence. Establishing a link between antenatal maternal anxiety and an objective measure of sustained attention/self-regulation, our results extend the growing evidence for an association between antenatal maternal anxiety and the neurobehavioral development of the offspring up into adolescence.     

Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study

Background: Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternal factors. We aimed to determine the role of maternal anxiety and depression in mediating the risk for feeding difficulties in infants of women with ED. Methods: A prospective study comparing women with lifetime ED (441) and without any lifetime psychiatric disorder (10,461) and their infants from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated the effect of: maternal anxiety and depression in late pregnancy (32 weeks) and the post‐partum (8 weeks), child temperament and developmental status on infant feeding difficulties at 1 and 6 months. We also investigated the effect of active pregnancy ED symptoms. We tested 3 models and their fit to the data using structured equation modelling: a direct effect model, a fully mediational model and an integrated (partial meditational) model. Results: The integrated model including a direct effect of maternal lifetime ED on infant feeding and a mediational path via maternal distress (a latent variable combining anxiety and depression) fitted the data best. This also applied to maternal pregnancy ED symptoms. Feeding difficulties in turn increased maternal distress over time. Conclusions: Lifetime ED and active pregnancy ED increase the risk for infant feeding difficulties and do so via maternal distress (i.e., depression and anxiety). This has important implications for prevention and early intervention in relation to infant feeding difficulties, as well as for future research in the field.     

Binge alcohol exposure once a week in early pregnancy predicts temperament and sleeping problems in the infant

Background

Prenatal alcohol exposure can cause several cognitive and behavioral difficulties. Few studies have investigated the associations with infant temperament or sleeping patterns. Our aim was to study potential associations between early prenatal binge exposure and infant temperament and sleeping pattern.

Methods

In a population based longitudinal study, representative of pregnant women in Oslo, questionnaires were answered at 17 and 30 weeks of pregnancy and 6 months after term. Two factors, difficult temperament and sleeping problems, were identified using Principal Component Analysis and dichotomized at the least optimal 14-15%. Logistic regression analyses identified predictive factors.

Results

Maternal binge drinking (≥ 5 drinks per occasion) once a week during pregnancy week 0-6 significantly predicted both difficult temperament (Odds Ratio OR 3.3**; 95% Confidence interval CI 1.4-7.9) and sleeping problems (OR 5.3**; 95% CI 2.1-13.7) in the infant, after adjusting for other confounding factors. Including binge drinking more often than once a week, further increased the OR of sleeping problems (6.0***; 2.7-13.7). Prenatal maternal depressive symptoms also predicted both outcomes. Reduced birth weight predicted difficult temperament. Maternal satisfaction with life reduced the probability of sleeping problems. Maternal smoking, and work stress, during pregnancy had no predictive power. The results were not explained by binge drinking later during pregnancy or higher consumption per occasion.

Conclusions

Binge drinking once a week during pregnancy week 0-6 had stronger predictive power of difficult temperament and sleeping problems during infancy, than other covariates. The findings support advising women to avoid binge drinking when planning pregnancy.     

Effects of maternal anxiety on perception of fetal movements in late pregnancy

BACKGROUND: To determine whether maternal state and trait anxiety levels affect maternal perception of fetal movements in the third trimester. METHOD: Forty healthy pregnant nulliparous women not on medication and with a singleton, uncomplicated pregnancy were studied. Maternal anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI, Form-Y) at 36 gestational weeks. At term (37- 40 gestational weeks), fetal movements were recorded simultaneously by the mother and by an ultrasound observer. The ultrasound transducer was positioned to include a cross-section of the fetal trunk and of at least one fetal limb. The ultrasound observer pressed a push-button for as long as she saw a fetal movement on the ultrasound screen. The screen was placed out of sight of the pregnant woman, who pressed another push-button for as long as she felt a fetal movement. The signals were fed into two different channels of a cardiotocograph. Fetal heart rate (FHR) was recorded throughout the examination and classified as FHR patterns A, B, C, or D. Examination time was 120 min. Agreement between maternally recorded and sonographically recorded fetal movements was determined manually for each FHR pattern and was compared between women with low and high state and trait anxiety. The low state anxiety group had STAI scores ranging from 20 to 31, and the high state anxiety group had STAI scores from 32 to 57. The corresponding values for the low and high trait anxiety groups were 20 to 29 and 30 to 54. RESULTS: The agreement between maternally perceived and ultrasonographically recorded fetal movements did not differ between women with low and high state and trait anxiety in any FHR pattern. CONCLUSION: This study does not support that maternal anxiety--within the normal range--affects perception of fetal movements in late pregnancy.     

Sequelae of infant colic: evidence of transient infant distress and absence of lasting effects on maternal mental health

BACKGROUND: Colic is widely believed to remit by 3 months of age, with little lasting effect on the infant or the family. OBJECTIVES: To determine the prevalence of colic at 3 months and the proportion of cases of colic (identified at 6 weeks) that remitted by 3 months; to identify the factors predictive of colic's remission; and to explore the potential lasting effects of colic on maternal mental health. DESIGN: Prospective cohort study of 856 mother-infant dyads. Self-administered questionnaires were mailed to mothers at 1 and 6 weeks and 3 and 6 months post partum. Standardized instruments were incorporated into the first and last questionnaires to assess maternal anxiety, postnatal depression, and social support. At 6 weeks and at 3 months, mothers completed the Barr diary and/or the Ames Cry Score. RESULTS: Data from 547 dyads were available for analysis. The prevalence of colic at 3 months was 6.4%. More than 85% of cases of colic had remitted by 3 months of age. These infants were more likely to be female, whereas the mothers of these infants were more likely to have received pain relief during labor/delivery and to have been employed during pregnancy. Reductions in scores for trait anxiety and postnatal depression, although smaller for mothers whose infants were colicky at 6 weeks of age, were not significantly different from those of mothers whose infants were never colicky. CONCLUSION: This study provides support for the belief that, in most cases, colic is self-limiting and does not result in lasting effects to maternal mental health.     

Postpartum maternal moods and infant size predict performance on a national high school entrance examination

Background: In an earlier series of studies, we documented the effects of feeding practices and postnatal maternal mood on the growth and development of 226 Barbadian children during the first few months of life. In this report, we extend our earlier studies by examining predictive relationships between infant size, feeding practices and postpartum maternal moods and scores on a national high school examination, the Common Entrance Examination (CEE), at 11 to 12 years of age. Methods: Feeding practices, anthropometry, and maternal moods, using Zung depression and anxiety scales and a morale scale, were assessed at 7 weeks (n = 158), 3 months (n = 168), and 6 months (n = 209) postpartum. Background variables including sociodemographic and home environmental factors were also assessed during infancy. CEE scores on 169 of the children in the original study were obtained from the Ministry of Education of Barbados. Results: In our sample of 86 boys and 83 girls, we found that reduced infant lengths and weights at 3 and 6 months of age were predictive of lower CEE, especially math scores. Children who were smaller at these early ages had significantly lower scores on the examination than did larger children. Postpartum maternal moods, including reports of despair and anxiety, were also found to be significant predictors of lower CEE scores, especially English scores. However, breast‐feeding and other feeding practices were not directly associated with the CEE scores. Background variables, which significantly predicted lower CEE scores, included young maternal age at the time of her first pregnancy, more children in the home, less maternal education, and fewer home conveniences. Significant associations between infant anthropometry, maternal moods and CEE scores were all significant even when these background variables were controlled for. Conclusions: These findings have important implications for developing interventions early in life to improve academic test scores and future opportunities available to children in this setting.     

Effects of mothers' prenatal psychiatric status and postnatal caregiving on infant biobehavioral regulation: can prenatal programming be modified?

BACKGROUND: Animal research suggests that antenatal stress exposure and postnatal rearing style act in concert to shape offspring biobehavioral outcomes. However, the combination of these maternally-mediated influences has not been studied in human infants. AIMS: To examine antenatal psychiatric status and maternal sensitivity in relation to 4-month-olds' autonomic regulation, HPA-axis functioning, and behavior. STUDY DESIGN: Prospective study of 47 pregnant women recruited from an urban hospital who completed questionnaire measures of anxiety and depression and underwent a psychiatric interview in the 2nd trimester. At 4 months postpartum, women again completed mood questionnaires and the mother-infant dyads participated in a 10-minute free-play session evaluated for maternal sensitivity. OUTCOME MEASURES: Baseline infant salivary cortisol and electrocardiogram (EKG) collected at the start of the 4-month sessions. Infant responsiveness and maternal report of temperament also were evaluated. RESULTS: Maternal sensitivity, but not antenatal psychiatric diagnosis, predicted greater levels of infant high frequency heart rate variability, after controlling for birth weight and age. Maternal sensitivity, but not psychiatric status, also predicted infant responsiveness. Maternal sensitivity modulated the effects of psychiatric illness on infant cortisol such that cortisol was low regardless of sensitivity for children of healthy women yet higher if the infant had insensitive versus sensitive caregiving when the mother had had an antenatal diagnosis. CONCLUSIONS: Biobehavioral adaptation, even that initiated in utero, is influenced by interactions with the social world. These findings support the compatibility of fetal programming and social-context models of infant biobehavioral development and have promising implications for pre and postnatal clinical intervention.     

Pre-discharge anxiety among mothers of well newborns: prevalence and correlates

OBJECTIVE: To explore the prevalence and correlates of maternal postpartum anxiety. METHODS: 422 of 973 invited mothers (43%) were screened for anxiety before hospital discharge with the State-Trait Anxiety Inventory (STAI). Recent medical and social life events, stress, resiliency (mastery, social support, and marital satisfaction), length of stay, discharge readiness, anticipatory medical care, and history of psychiatric illness and depression were assessed by questionnaire and medical record review. RESULTS: 24.9% of mothers had moderate and 1% severe anxiety. Higher anxiety was observed among young, unmarried, primiparous mothers with male infants, and anxiety correlated with medical and negative social life events, stress, history of depression, and duration of postpartum stay. Inverse correlations were observed with maternal education and household income, pregnancy planning, prenatal class attendance, infant healthcare provider identification, and with all resiliency factors. In multivariate models, pre-discharge anxiety was significantly associated with medical life events and the maternal perception of perinatal stress, and negatively associated with mastery, marital satisfaction, and choice of infant healthcare provider. CONCLUSION: Moderate maternal anxiety is common prior to perinatal hospital discharge, especially among women with low mastery and marital satisfaction, stressful perinatal courses, and failure to identify an infant healthcare provider.     

Characteristics at four months follow-up of infants born small for gestational age: a controlled study

This prospective study compared 65 small-for-gestational-age (SGA) (birth weight < 3rd centile) and 71 control infants at a corrected age of 4 months. It was hypothesised that differences would exist in growth, development, temperament and minor neurological signs and that these would be predicted by type (proportional/disproportional) of growth restriction at birth and maternal mood disturbance at birth or at 4 months. Infants had a Griffith's developmental test and neuromotor assessment. Maternal mood and infant temperament were surveyed. Few differences were found between SGA and control infants. SGA infants showed catch-up growth with 63% being above the third percentile and 43% being above the tenth percentile for weight. SGA infants had lower Griffith's GQ scores (97 vs. 102, P = 0.02) and they were rated in temperament as more manageable than controls. There were no differences in subtle neuromotor signs. Neither type of SGA nor maternal mood disturbance at birth had prognostic significance for infant catch up growth, neuromotor scores, or temperament though level of maternal stress and anxiety at 4 months were related to lower GQ scores in SGA infants.     

Maternal sensitivity moderates the impact of prenatal anxiety disorder on infant mental development

Background

Animal studies have shown that postnatal rearing style can modify the association between prenatal stress exposure and offspring neurodevelopmental outcomes. However, little is known about how parenting quality impacts the association between maternal prenatal anxiety and development in human infants.

Aim

This prospective study examined the impact of maternal prenatal anxiety disorder and maternal caregiving sensitivity on cognitive and psychomotor development in healthy, full-term, 7-month-old infants.

Measures

Women completed a clinical interview during the third trimester of pregnancy to assess anxiety symptoms meeting DSM-IV diagnostic criteria. At infant age 7 months, maternal sensitivity to infant distress and non-distress were observed and coded during the still-face procedure. Maternal postnatal (concurrent) anxiety and depression were also assessed at this time. Infant mental and psychomotor development was assessed at infant age 7 months using the Bayley Scales of Infant Development II.

Results

Analyses were based on 77 mother-infant dyads. Maternal sensitivity to infant distress moderated the association between maternal prenatal anxiety disorder and infant mental development, F (1, 77) = 5.70, p = .02. Whereas there was a significant positive association between sensitivity and mental development among infants whose mothers were anxious during pregnancy, sensitivity had little impact on mental development among infants of control (non-anxious) women. Results were independent of prenatal depression and postnatal anxiety and depression. A caregiving moderation effect was not found for infant psychomotor development, p > .10.

Conclusions

These findings are consistent with a cumulative risk model suggesting that maternal prenatal anxiety and quality of maternal care act in concert to shape infant outcomes.     

Antenatal maternal anxiety is linked with atypical handedness in the child

BACKGROUND: Animal studies have shown that prenatal stress is linked with altered laterality in the offspring. AIMS: The aim of this study was to test the hypothesis that antenatal maternal anxiety was associated with altered lateralisation in children, as demonstrated by mixed handedness. STUDY DESIGN AND SUBJECTS: We used the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective longitudinal study that has followed women since pregnancy. The final analysis included data on 7431 mother-child pairs. Maternal anxiety was measured at 18- and 32-week gestation and 8 weeks postnatally using a self-report inventory. Child handedness was assessed at 42 months using an established maternal report scale. Information on maternal and paternal handedness, as well as data on possible confounding variables such as obstetric and antenatal risks, were also assessed. RESULTS: Univariable analysis showed that antenatal anxiety at 18 weeks was associated with mixed-handedness in the child, OR=1.28 (95% CI 1.09-1.50, p<0.01). Although boys were more likely than girls to be mixed handed, the link with antenatal anxiety was similar. There was no significant association with antenatal anxiety at 32 weeks. Multivariable analyses indicated that maternal anxiety at 18 weeks of pregnancy predicted an increased likelihood of mixed-handedness in the child (OR=1.23, 95% CI 1.02-1.48, p<0.05), independently of parental handedness, obstetric and other antenatal risks, and postnatal anxiety. CONCLUSION: This result provides further evidence for a link between antenatal anxiety and fetal programming in humans.     

Maternal depression and infant cortisol: influences of timing, comorbidity and treatment

Background: The current study examines the relationship between maternal depression and infant cortisol concentrations. The potential roles of comorbid maternal anxiety disorders, timing of maternal depression, and maternal treatment with psychotropic medications during pregnancy are addressed. Methods: Women with 6‐month‐old infants (105 boys and 84 girls) participated in a laboratory paradigm that included infant saliva collection at six points, noise burst and arm restraint stressor tasks, and a diagnostic interview of the mother. Results: Lifetime history of maternal depression was associated with increased baseline and mean (average) infant cortisol levels. Comorbidity with anxiety disorder was related to infant cortisol reactivity. Peripartum (prepartum and/or postpartum) maternal depression, rather than a pre‐pregnancy history of disorder, was associated with higher infant cortisol reactivity. Prenatal and postnatal exposure to maternal disorder had similar effects, but prenatal maternal psychotropic medication treatment appeared to attenuate infant cortisol increases associated with prenatal maternal disorder exposure. Conclusions: These data suggest that exposure to maternal depression and anxiety during pregnancy and the postpartum period may increase infant salivary cortisol. This maternal depression–infant cortisol association is independent of the effects of delivery complications, and appears to be modulated by prenatal maternal psychotropic treatment.     

Early childhood factors influencing health-related quality of life in adolescents at 13 years

OBJECTIVE: To understand the relationship of health-related quality of life (HR-QOL) to early life experience. METHODOLOGY: Eight thousand five hundred and fifty-six women enrolled in a prospective study at their first antenatal clinic visit. At 13 years, of 5345 women remaining, a consecutive sample of 901 mother/child pairs provided data on adolescent HR-QOL using the Child Health Questionnaire-Parent Report form (CHQ-PF50) and the Dartmouth COOP Functional Assessment Charts for Adolescents. The CHQ-PF50 yielded physical (PHS) and psychosocial (PSS) summary scores. We examined the relationship between health-related QOL and early childhood predictive variables. RESULTS: PHS was related to gestation, maternal health symptoms in pregnancy, maternal anxiety at 6 months, child health and hours of childcare at 5 years (P < 0.05). PSS was related to maternal age at index visit, maternal attitude to pregnancy, maternal satisfaction with care giving and maternal depression at 6 months, and child health and behaviour problems at 5 years (internalizing and social/attentional/thought (SAT) domains) (P < 0.05). Findings from adolescent self-reports were similar. CONCLUSIONS: This study has identified a number of early childhood determinants of adolescent HR-QOL. These findings add to evidence of the effects of early adversity on the developmental pathways of children and support the need for effective early intervention.     

Infantile colic, prolonged crying and maternal postnatal depression

Aim:  To study if infant crying is associated with maternal postnatal depression.
Methods:  Data from 1015 mothers and their children participating in a prospective European multicentre study were analysed. Infantile colic and prolonged crying were defined as excessive crying as reported by the mothers 2 and 6 months after delivery, and at the same time the mothers completed the Edinburgh Postnatal Depression Scale (EPDS).
Results:  In cross-sectional analyses, infant crying was associated with high EPDS scores both 2 (OR: 4.4; 95% CI: 2.4–8.2) and 6 months postpartum (OR: 10.8; 95% CI: 4.3–26.9). More than one-third of the others of infants with prolonged crying had high EPDS scores 6 months postpartum. Longitudinal analyses showed that mothers of infants with colic had increased odds of having high EPDS scores 6 months after delivery even if crying had resolved (OR: 3.7; 95% CI: 1.4–10.1).
Conclusion: Both infantile colic and prolonged crying were associated with high maternal depression scores. Most noteworthy, infantile colic at 2 months of age was associated with high maternal depression scores
4 months later.     

A prospective study of maternal anxiety, perceived stress, and depressive symptoms in relation to infant cognitive development

Aim

Our objective was to examine the associations between maternal psychological health (trait anxiety, perceived stress, and depressive symptoms) during pregnancy or postpartum and infant visual, language, motor, and overall cognitive development.

Study Design and Methods

In the prospective Pregnancy, Infection, and Nutrition Study (2001-2006), central North Carolina women completed self-administered questionnaires during pregnancy to assess trait anxiety and depressive symptoms. An in-person interview assessed maternal perceived stress and depressive symptoms in the 4th postpartum month. Infant development was assessed at 12 months using the Mullen Scales of Early Learning (n = 358). Multiple linear regression with restricted cubic splines was used to examine potential non-linear associations between trait anxiety, perceived stress, and depressive symptoms in relation to Mullen sub-scales and Composite scores.

Results

Increasing maternal anxiety was associated with poorer overall cognition (adjusted β for Composite = − 0.2, 95% CI: −0.4, 0.0). Postpartum stress was positively associated with language development and general cognition (adjusted β for Expressive Language = 0.2, 95% CI: 0.0, 0.4; adjusted β for Composite = 0.3, 95% CI: 0.0, 0.6). Elevated depressive symptoms throughout pregnancy and postpartum were associated with better fine motor skills (adjusted β = 9.7, 95% CI: 3.9, 15.5). Anxiety, postpartum depressive symptoms and stress were associated with gross motor skills in a non-linear fashion, as were postpartum depressive symptoms and stress with expressive language.

Conclusions

Maternal trait anxiety, depressive symptoms and stress had little negative influence on infant cognitive development. In fact, moderate psychosocial distress may slightly accelerate motor development in particular, and some aspects of language.     

Improving infant sleep and maternal mental health: a cluster randomised trial.

OBJECTIVES: To determine whether a community-delivered intervention targeting infant sleep problems improves infant sleep and maternal well-being and to report the costs of this approach to the healthcare system. DESIGN: Cluster randomised trial. SETTING: 49 Maternal and Child Health (MCH) centres (clusters) in Melbourne, Australia. PARTICIPANTS: 328 mothers reporting an infant sleep problem at 7 months recruited during October-November 2003. INTERVENTION: Behavioural strategies delivered over individual structured MCH consultations versus usual care. MAIN OUTCOME MEASURES: Maternal report of infant sleep problem, depression symptoms (Edinburgh Postnatal Depression Scale (EPDS)), and SF-12 mental and physical health scores when infants were 10 and 12 months old. Costs included MCH sleep consultations, other healthcare services and intervention costs. RESULTS: Prevalence of infant sleep problems was lower in the intervention than control group at 10 months (56% vs 68%; adjusted OR 0.58 (95% CI: 0.36 to 0.94)) and 12 months (39% vs 55%; adjusted OR 0.50 (0.31 to 0.80)). EPDS scores indicated less depression at 10 months (adjusted mean difference -1.4 (-2.3 to -0.4) and 12 months (-1.7 (-2.6 to -0.7)). SF-12 mental health scores indicated better health at 10 months (adjusted mean difference 3.7 (1.5 to 5.8)) and 12 months (3.9 (1.8 to 6.1)). Total mean costs including intervention design, delivery and use of non-MCH nurse services were 96.93 pounds sterling and 116.79 pounds sterling per intervention and control family, respectively. CONCLUSIONS: Implementing this sleep intervention may lead to health gains for infants and mothers and resource savings for the healthcare system. TRIAL REGISTRATION: Current Controlled Trial Registry, number ISRCTN48752250 [controlled-trials.com] (registered November 2004).     

Maternal anxiety is related to infant neurological condition, paternal anxiety is not

Background

Parental anxiety and stress may have consequences for infant neurological development.

Aims

To study relationships between parental anxiety or well-being and infant neurological development approximately one year after birth.

Study design

Longitudinal study of a birth cohort of infants born to subfertile couples. Subjects: 206 parent-child dyads.

Outcome measures

Infant neurology was assessed with the Touwen Infant Neurological Examination (TINE) at 10 months and a developmental questionnaire at 12 months. Parental measures included trait anxiety measured by the State-Trait Anxiety Inventory (STAI) and well-being measured by the General Health Questionnaire (GHQ).

Results

Maternal trait anxiety was associated with a less optimal neurological condition (r_s = − 0.19, p < 0.01) of the infant. This association persisted after adjusting for confounders and results were confirmed by the outcome of the developmental questionnaire. Paternal trait anxiety and parental well-being were not related to the infant's neurodevelopmental outcome.

Conclusions

Infants of mothers with high trait anxiety have an increased vulnerability to develop a non-optimal nervous system. The association may be mediated in part by early programming of monoaminergic systems. Future research should include an exploration of specific windows of vulnerability to maternal anxiety.     

Is difficult temperament related to overweight and rapid early weight gain in infants? A prospective cohort study

OBJECTIVE: Childhood overweight and rapid weight gain during the first months of life have been shown to be major risk factors for the development of later overweight. Studies in children show that there are temperamental risk factors for the development of overweight, but little is known about early infancy. METHODS: The present study investigated the relationship of infant difficult temperament, assessed at age 6 months, with overweight status at birth and at 6 months of age and with rapid weight gain during this period. Data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health (1999-2006). The analyses are based on data retrieved from the Medical Birth Registry of Norway, health charts, and maternal reports during pregnancy and when the child was 6 months of age. After application of eligibility criteria, 29,182 infants could be included in the study. RESULTS: In adjusting for infants' sex, formula feeding, maternal age, body mass index and diabetic status, and parental duration of education, infant difficult temperament was slightly negatively associated with overweight status at birth but not at age 6 months. In addition, infant difficult temperament was slightly positively associated with rapid weight gain during the first 6 months of life. CONCLUSIONS: Despite statistical significance, these associations do not appear to be clinically relevant. Future studies should explore whether the impact of temperament increases with age.     

THE TEMPERAMENT OF DOWN''S SYNDROME TODDLERS: A RESEARCH NOTE

A toddler temperament questionnaire was completed by the mothers of fifteen Down's syndrome children who had been assessed two years earlier with the Carey infant temperament questionnaire. The results suggest that infants who have been scored as showing signs of difficult temperament move towards the easier signs on the toddler scale. If these temperament questionnaires are biased by maternal perceptions, this move may reflect a reduced level of maternal anxiety.