Maternal depression and perceived social support as predictors of cognitive function trajectories during the first 3 years of life for preterm infants in Wisconsin

Background Among families of infants born preterm, the association between post‐natal depression and children's cognitive function is not well understood, but thought to be compromised. The purpose of this study is to investigate maternal depressive symptoms and perceived social support as predictors of children's cognitive function trajectories. Methods This is a longitudinal study of a sample of infants born preterm (less than 37 weeks) in Wisconsin. This study includes 130 infants who were hospitalized in one of three Wisconsin neonatal intensive care units in 2002–2005 and followed until 36 months of age. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Social support was measured using the Maternal Support Scale. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd Edition, and the Stanford–Binet Intelligence Scale, 5th Edition. Results Children's cognitive function trajectories declined initially and then increased. Being female (coefficient = 5.14, SE = 1.89) and non‐poor (coefficient = 11.26, SE = 5.78), and having a mother who has a graduate degree (coefficient = 7.67, SE = 3.37) was associated with higher levels of cognition initially. Being white was associated with a more optimal cognitive trajectory. Although depression did not predict children's cognitive trajectories, the presence of clinically elevated depressive symptoms at 9 months post term was associated with lower cognitive functioning at 16 months when mothers reported low social support. Conclusion Post‐natal depressive symptoms appear to have a meaningful, dynamic influence on the cognitive outcomes of children born preterm, above and beyond family socio‐demographic risk when the presence and timing of perceived social support are considered. Interventions to ameliorate developmental risk associated with preterm birth should include repeated assessments of maternal social support and post‐natal depression and be targeted towards socially disadvantaged families.     

How do mothers’ childrearing histories,stress and parenting affect children's behavioural outcomes?

BACKGROUND: Information is needed to understand the role of low to moderate levels of mothers' emotional stress and child characteristics (i.e. prematurity) on parenting behaviours and their impact on children's behaviour that might be deemed 'challenging' but not 'disordered'. METHODS: The direct and indirect relations of maternal childrearing history and emotional stress, and observed parenting practices when children were 3 years of age on 4-year child behavioural outcomes was examined in a sample of low-income families with a term (n=112) or preterm (n=180) child. Parenting practices included displays of warmth and restrictiveness when interacting with their children. Child outcomes at 4 years included observation of social initiations with their mothers and maternal report of social and attentional problems. RESULTS: A Structural Equation Model building approach guided by specific hypotheses indicated that preterm as compared to full-term children had more maternal reported social and attentional problems but did not differ in observed social initiating skills. Greater negative maternal childrearing history indirectly influenced social initiating skills through its direct influence on maternal emotional stress. Greater maternal emotional stress directly influenced mothers' parenting that, in turn, directly influenced social initiating. Prematurity and a more negative childrearing history had a direct negative influence on the maternal report of social and attentional behavioural outcomes. CONCLUSIONS: These findings delineate the effects of prematurity and maternal parenting on the behaviour of 4-year-old-children and extend current knowledge of the influence of parental emotional stress on parenting. Even milder levels can negatively influence parenting, and in turn, contribute to children's less well developed social skills. The issues raised in this study could help with the identification and prioritization of medical and psychological services.     

Effects of welfare reform on children of adolescent mothers: moderation by maternal depression, father involvement, and grandmother involvement

There are few data available on how effects of welfare reform on children may differ for different kinds of families. This study examined the constructs of maternal depression, father involvement, and grandmother involvement as moderators of the effects of a welfare reform program on children. The sample included 1,602 children between the ages of 3 and 6 1/2 whose mothers had participated in New Chance, a multi-site welfare-to-work program with an emphasis on human capital development (i.e., education, job training). Father and grandmother co-residence were investigated, in addition to perceived support from these family members, in predicting cognitive and behavioral child outcomes. The mediating roles of parenting stress and emotional support in parenting were also explored. Although main effects were found for the intervention and for maternal depression, no main effects were found for the family ecology variables. However, interactions suggested complex relationships among New Chance and the family characteristics for both the full sample and for Latina families. Results are discussed in terms of policy implications and possible future research.     

The impact of maternal post-partum depression on the language development of children at 12 months

Background Language is one of the most important acquisitions made during childhood. Before verbal language, a child develops a range of skills and behaviours that allow the child to acquire all communication skills. Factors such as environmental factors, socio‐economic status and interaction with parents can affect the acquisition of vocabulary in children. Post‐partum depression can negatively affect the first interactions with the child and, consequently, the emotional, social and cognitive development of the child. Objective To analyse the effect of the duration of the mother's depression on the language development of children at 12 months old. Methods This was a longitudinal study. The participants of this study were mothers who had received prenatal care from the Brazilian National System of Public Health in Pelotas city, State of Rio Grande do Sul, Brazil. The mothers were interviewed at two different time points: from 30 to 90 days after delivery and at 12 months after delivery; the children were also evaluated at this later time point. To diagnose maternal depression, we used the Mini International Neuropsychiatric Interview, and to assess child development, we used the language scale of the Bayley Scales of Infant Development III. Results We followed 296 dyads. Maternal depression at both time points (post partum and at 12 months) was significantly associated with the language development of infants at 12 months of age. This impact was accentuated when related to the duration of the disorder. Older women and women with more than two children were more likely to have children with poorer language development, while women who were the primary caregiver had children with higher scores on the language test. Conclusion The findings indicate that maternal age, parity, primary caregiver status and duration of post‐partum depression are associated with the language development of the child.     

Effects of Welfare Reform on Children of Adolescent Mothers: Moderation by Maternal Depression,Father Involvement,and Grandmother Involvement

SUMMARY

There are few data available on how effects of welfare reform on children may differ for different kinds of families. This study examined the constructs of maternal depression, father involvement, and grandmother involvement as moderators of the effects of a welfare reform program on children. The sample included 1,602 children between the ages of 3 and 6 ½ whose mothers had participated in New Chance, a multi-site welfare-to-work program with an emphasis on human capital development (i.e., education, job training). Father and grandmother co-residence were investigated, in addition to perceived support from these family members, in predicting cognitive and behavioral child outcomes. The mediating roles of parenting stress and emotional support in parenting were also explored. Although main effects were found for the intervention and for maternal depression, no main effects were found for the family ecology variables. However, interactions suggested complex relationships among New Chance and the family characteristics for both the full sample and for Latina families. Results are discussed in terms of policy implications and possible future research.     

New Mothers and Media Use: Associations Between Blogging, Social Networking, and Maternal Well-Being

Drawing on Bronfenbrenner's ecological theory and prior empirical research, the current study examines the way that blogging and social networking may impact feelings of connection and social support, which in turn could impact maternal well-being (e.g., marital functioning, parenting stress, and depression). One hundred and fifty-seven new mothers reported on their media use and various well-being variables. On average, mothers were 27?years old (SD?=?5.15) and infants were 7.90?months old (SD?=?5.21). All mothers had access to the Internet in their home. New mothers spent approximately 3?hours on the computer each day, with most of this time spent on the Internet. Findings suggested that frequency of blogging predicted feelings of connection to extended family and friends which then predicted perceptions of social support. This in turn predicted maternal well-being, as measured by marital satisfaction, couple conflict, parenting stress, and depression. In sum, blogging may improve new mothers' well-being, as they feel more connected to the world outside their home through the Internet.     

Contribution of Parenting Factors to the Developmental Attainment of 9-Month-Old Infants: Results From the Japan Children’s Study

Background

Child development integrates several interdependent domains, but few studies have attempted to identify the common factors that contribute to these different domains of development in infancy. The aim of the present study was to identify the factors that contribute to several domains of developmental attainment in 9-month-old infants.

Methods

We used data from the Japan Children’s Study, a prospective cohort study underway in Japan since 2005. Mothers completed questionnaires about their children’s temperament, coparenting behaviors, maternal parenting stress, and parenting behavior. The Kinder infant development scale was used to evaluate child development outcomes.

Results

A total of 270 children were included in this analysis. After adjusting for the children’s birth weight, gestational age, temperament, and other family environmental variables, multiple logistic regression analyses showed that greater maternal cognitive stimulation was associated with the development of receptive language, expressive language, social relationships, and feeding. Results also suggest that early supportive coparenting helped to promote development in manipulation, receptive language, and social relationships. Maternal parenting stress was stable between the infant ages of 4 and 9 months and was negatively correlated with scores for coparenting and maternal stimulation, which suggests an indirect effect of maternal parenting stress on child outcomes.

Conclusions

Supportive coparenting and maternal cognitive stimulation were the most important contributors to most domains of child development. Our findings suggest that educational interventions targeting young families would help parents establish and maintain an environment of successful coparenting and cognitive stimulation as their children grow.Key words: development, coparenting, maternal stimulation, parenting stress, prospective study     

Effects of combining public assistance and employment on mothers and their young children

One goal of recent welfare reform legislation is to move welfare-dependent mothers with young children into the paid labor force. However, prior to the new legislation, many welfare-dependent women were already engaged in employment activities. In this paper we examine whether child or maternal well-being is influenced by a mother's strategy of combining work and public assistance receipt in the late 1980s. Measures of well-being include children's cognitive test scores and behavior problems, parenting behavior, and maternal mental health, social support, and coping strategies collected when children were 2 1/2 to 3 years of age. Data from the Infant Health and Development Program (a sample of low birthweight, premature infants born in 8 sites in 1985) were used to identify low-income families (incomes under 200% of the poverty threshold; N = 525). Comparisons were made among mothers in the following groups: (a) Work Only, (b) Some Work-Some Welfare, (c) Some Work-No Welfare, (d) No Work-No Welfare, and (e) Welfare Only. Mothers in the Some Work-Some Welfare group had children with cognitive and behavioral scores similar to children whose mothers were in the Work Only group; these two groups also had similar mental health, social support, and coping scores. However, not working and receiving welfare (Welfare Only) was associated with negative cognitive and behavioral outcomes for children, with less stimulating home learning environments, lower maternal mental health, less social support, and more avoidant coping strategies. We discuss the proposition that welfare and work may be complementary rather than opposing strategies, in terms of putting together a family income package.     

The Relationship of Women's Role Strain to Social Support,Role Satisfaction,and Self‐Efficacy*

The relationship of social support, role satisfaction, and self‐efficacy to measures of role strain was explored in a sample of 129 married, employed women with at least 1 preschool‐aged child. Self‐efficacy in work and parental roles proved to be a significant predictor of these women's work‐family conflict and role overload, respectively. In addition, satisfaction with their child care was related to significantly less anxiety about being separated from their young children. Spousal and supervisor support also accounted for significant variation in work‐family conflict, but the impact of organizational support on role conflict was fully mediated by job self‐efficacy.     

The Effect of the WIC Program on the Health of Newborns

Objective. To determine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on birth outcomes. Data Source. The Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID). The PSID provides extensive data on the income and well‐being of a representative sample of U.S. families from 1968 to present. The CDS collects information on the children in PSID families ranging from cognitive, behavioral, and health status to their family and neighborhood environment. The first two waves of the CDS were conducted in 1997 and 2002, respectively. We use information on 3,181 children and their mothers. Study Design. We use propensity score matching with multiple imputations to examine whether WIC program influences birth outcomes: birth weight, prematurity, maternal report of the infant's health, small for gestational age, and placement in the neonatal intensive care unit. Furthermore, we use a fixed‐effects model to examine the above outcomes controlling for mother‐specific unobservables. Principal Findings. After using propensity scores to adjust for confounding factors, WIC shows no statistically significant effects for any of six outcomes. Fixed‐effects models, however, reveal some effects that are statistically significant and fairly substantial in size. These involve preterm birth and birth weight. Conclusions. Overall, the WIC program had moderate effects, but findings were sensitive to the estimation method used.     

The influence of maternal depression, caregiving, and socioeconomic status in the post-natal year on children's language development

Background   Post-natal depression is common and has been associated with adverse effects on children's later emotional and behavioural development. The evidence for effects on children's cognitive development is unclear but this could potentially be a major public health issue. The aim was to examine whether maternal depression and maternal caregiving during the first year of life are associated with children's subsequent language development.
Methods   One thousand two hundred and one women were recruited from antenatal and post-natal baby clinics in two areas in England, and followed up until their babies were 3 years. Mothers and children were assessed by questionnaire, interview and home observation; 999 children's language was assessed at 36 months, although 55 were excluded principally because they had been exposed to insufficient English.
Results   In bivariate analyses maternal depressive symptomatology in the post-natal year but not at 36 months was associated with poorer child language at 36 months; maternal caregiving, was positively associated with language. Structural Equation Modelling revealed that depression was associated with poorer caregiving but was not independently associated with language. Higher quality caregiving at 10 months was associated with better language. When the sample was split by socioeconomic factors the effects of depression on caregiving were stronger in the less advantaged group. In both groups poorer quality early caregiving predicted lower language outcome.
Conclusions   Post-natal depression had a negative effect on caregiving, which in turn affected language; post-natal depression did not have an additional direct effect on language. Socioeconomic factors moderated the effects of depression on caregiving. When targeting interventions at mothers with post-natal depression, it may be strategic to focus on lower socioeconomic groups at higher risk.     

Maternal social capital and child health in Vietnam

STUDY OBJECTIVE: To explore the association between maternal social capital and child physical and mental health in Vietnam. DESIGN: Cross sectional survey. Measures of maternal structural social capital comprised group membership, citizenship, and social support. Measures of cognitive social capital comprised trust, social harmony, sense of fairness, and belonging. Child health was measured by anthropometrics and mothers' reports of acute and chronic physical health problems and child mental health. PARTICIPANTS: 2907 mothers and their 1 year old or 8 year old children from five provinces in Vietnam. MAIN RESULTS: The study found low levels of group membership and citizenship and high levels of cognitive social capital and support, and generally higher levels of social capital among the mothers of 8 year old compared with 1 year old children. All but one association was in the hypothesised direction (that is, higher levels of social capital associated with reduced risk of child health problems). There were more statistically significant relations between maternal social capital and the health of 1 year olds compared with 8 year old children, and between measures of social support and cognitive social capital and child health, than with group membership and involvement in citizenship activities. CONCLUSION: This study is the first to explore the association between multiple dimensions of social capital and a range of different child health outcomes in the developing world. These results now need to be tested using longitudinal data.     

Maternal Depressive Symptoms Mediate the Association between Socio-economic Status and Adolescent Weight Outcomes: A Longitudinal Analysis

Introduction The prevalence of pediatric obesity is an issue in the United States, in which approximately one-third of children and adolescents are overweight or obese. Youth living in low socioeconomic (SES) households are at an increased risk for developing obesity; yet, research is needed to understand the mechanisms that might better explain the relationship between SES and obesity risk. Maternal depression presents a potential mechanism by which SES might predict a later risk for obesity in pediatric populations. Methods The present study used a national dataset from the National Institute of Child Health and Human Development—Study of Early Child Care and Youth Development (NICHD-SECCYD) to examine whether maternal depressive symptoms (at an age of 9 years) mediated the association between early SES (the income-to-needs ratio measured at an age of 1 month) and adolescent weight outcomes [Body Mass Index z-scores (zBMI) for age and sex, at an age of 15 years]. Results The results suggested that greater maternal depressive symptoms helped to explain a significant amount of the variance of lower SES predicting poorer weight outcomes in adolescents. Discussion These findings illustrate the role of maternal depressive symptoms in explaining how SES predicts adolescent weight outcomes. Implications are discussed, and future research is needed to identify women from lower SES households who are experiencing depressive symptoms to provide support and initiate points of early intervention to address relevant health outcomes in youths.     

Breastfeeding and the Child Cognitive Outcomes: A Propensity Score Matching Approach

To estimate the effect of breastfeeding initiation and duration on child development outcomes. 3,271 children and their mothers participating in the Child Development Supplement of the Panel Study of Income Dynamics provide data for these analyses. Main outcomes include Woodcock Johnson Psycho-Educational Battery-Revised (WJ-R) test score (letter word, passage comprehension, applied problem, and broad reading), and Wechsler Intelligence Scale for Children-Revised (WISC-R) test score at the 2002 survey. Controlled variables include family, maternal, and child characteristics, many of which can be traced back to the year the child was born. The analytic technique is propensity score matching with multiple imputations. After using propensity scores to adjust for confounding factors, breastfeeding initiation showed statistically significant effects but the practical scale remains small. Breastfeeding duration showed a non-linear effect on those outcomes and most of the effects are not significant. The effects of breastfeeding on child’s cognitive outcomes are modest in practical terms. The non-linear effects suggest that selection into breastfeeding may account for the increased score of children who are breastfed.     

Effects of Combining Public Assistance and Employment on Mothers and Their Young Children

SUMMARY

One goal of recent welfare reform legislation is to move welfare-dependent mothers with young children into the paid labor force. However, prior to the new legislation, many welfare-dependent women were already engaged in employment activities. In this paper we examine whether child or maternal well-being is influenced by a mother's strategy of combining work and public assistance receipt in the late 1980s. Measures of well-being include children's cognitive test scores and behavior problems, parenting behavior, and maternal mental health, social support, and coping strategies collected when children were 2 ½ to 3 years of age. Data from the Infant Health and Development Program (a sample of low birthweight, premature infants born in 8 sites in 1985) were used to identify low-income families (incomes under 200% of the poverty threshold; N = 525). Comparisons were made among mothers in the following groups: (a) Work Only, (b) Some Work-Some Welfare, (c) Some Work-No Welfare, (d) No Work-No Welfare, and (e) Welfare Only. Mothers in the Some Work-Some Welfare group had children with cognitive and behavioral scores similar to children whose mothers were in the Work Only group; these two groups also had similar mental health, social support, and coping scores. However, not working and receiving welfare (Welfare Only) was associated with negative cognitive and behavioral outcomes for children, with less stimulating home learning environments, lower maternal mental health, less social support, and more avoidant coping strategies. We discuss the proposition that welfare and work may be complementary rather than opposing strategies, in terms of putting together a family income package.     

Neighbourhood and family influences on the cognitive ability of children in the British National Child Development Study

This paper investigates the association between family poverty, the level of deprivation in electoral wards and children's cognitive test scores using data from the second generation in the 1991 sweep of the British National Child Development Study (1958 birth cohort). Family poverty has a significant association with lower test scores in children of all ages (4-18 years). Neighbourhood poverty has a significant association with lower test scores in children aged 4-5 years which, though somewhat attenuated, is independent of other socioeconomic indicators. Among children aged between 6 and 9 years, the association with neighbourhood deprivation is statistically accounted for by individual characteristics. Among children aged between 10 and 18 years, levels of neighbourhood deprivation were for the most part statistically insignificant. The family poverty--test score association among children aged between 10 and 18 years was mediated by the home environment. Mediated effects were stronger for family poverty--test score associations than for neighbourhood poverty. The use of a neighbourhood-level exposure related to the social environment leads to an understanding of the social determinants of children's outcomes that is more than the sum of individual and family-level measures. However, the size of the estimated effects of neighbourhood conditions is much smaller than the estimated effects of family-level conditions. Thus, it appears that families still should be viewed as the key agents in promoting positive development in children.     

The impact of support network substitution on low-income women's health: Are minor children beneficial substitutes?

Poor women have elevated stress but also face deficits in their social networks to provide help. Consequently, they may substitute their minor children as a support source in place of more traditional ties. Support substitution and compensation theory suggest this form of substitution may not lead to compensatory benefits. We hypothesized that low-income mothers experiencing high levels of acute and network stress would be more likely to rely on their minor children, and this reliance on minor children would be related to worse health outcomes through its impact on minor children's well-being. In an interview-based community study of 116 low-income mothers from Northeast Ohio, USA we found that acute stress (but not network stress) was related to greater reliance on minor children for support and the impact on minor children's well-being mediated the link with low-income mothers' worse health outcomes. These results suggest that the reason for and type of social network substitution may determine whether compensatory benefits are realized.     

The Long-Term Effects of Maternal Depression: Early Childhood Physical Health as a Pathway to Offspring Depression

PurposeCross-sectional and retrospective studies have highlighted the long-term negative effects of maternal depression on offspring physical, social, and emotional development, but longitudinal research is needed to clarify the pathways by which maternal depression during pregnancy and early childhood affects offspring outcomes. The current study tested one developmental pathway by which maternal depression during pregnancy might negatively impact offspring mental health in young adulthood, via poor physical health in early childhood.MethodsThe sample consisted of 815 Australian youth and their mothers who were followed for 20 years. Mothers reported on their own depressive symptoms during pregnancy and offspring early childhood. Youth completed interviews about health-related stress and social functioning at age 20 years, and completed a questionnaire about their own depressive symptoms 2 to 5 years later.ResultsPath analysis indicated that prenatal maternal depressive symptoms predicted worse physical health during early childhood for offspring, and this effect was partially explained by ongoing maternal depression in early childhood. Offspring poor physical health during childhood predicted increased health-related stress and poor social functioning at age 20. Finally, increased health-related stress and poor social functioning predicted increased levels of depressive symptoms later in young adulthood. Maternal depression had a significant total indirect effect on youth depression via early childhood health and its psychosocial consequences.ConclusionsPoor physical health in early childhood and its effects on young adults' social functioning and levels of health related stress is one important pathway by which maternal depression has long-term consequences for offspring mental health.     

Continuing Education Mitigates the Negative Consequences of Adolescent Childbearing

Beginning childbearing during adolescence is consistently linked with negative outcomes for both children and parents. Many have attributed this association to maternal background characteristics which are often difficult to change through policy. Though maternal educational attainment is often a side effect of adolescent childbearing, it also represents a potential avenue through which we can help young mothers overcome the obstacles associated with an early birth. The data for this study come from the 1997 Child Development Supplement of the Panel Study of Income Dynamics, a nationally representative sample of mothers and their children (N = 3,193). Data are used to explore the cognitive stimulation and emotional support in the home, measured using the HOME Scale (Caldwell and Bradley in Home observation for measurement of the environment. University of Arkansas at Little Rock, Little Rock, 1984). OLS regression models how maternal education moderates the association between age at first birth and quality of children’s home environment. Adolescent mothers scored significantly lower on the indicator of home environment than older mothers. However, when continuing education was considered, maternal age at first birth was no longer significantly associated with the home environment. The negative consequences of early births were mediated by adolescent mothers’ continuing education efforts. While interventions are needed to reduce adolescent childbearing, these results highlight the need to ensure that adolescent mothers are provided support to continue their education following delivery. The negative consequences of adolescent births are not inevitable. Encouraging school retention may help young mothers form a safe, healthy, nurturing, and developmentally appropriate home environment.     

Maternal social and pyschological conditions and physical growth in low-income children in Piauí, Northeast Brazil

Prevalence of child undernutrition remains high in many developing countries. In settings with scarce resources, modifiable maternal social conditions may influence feeding and parenting practices, in turn affecting child growth. This study aims to quantify the association between maternal social support and depression to children's physical growth outcomes in Teresina, Piauí, northeast Brazil. Interviews were conducted with a random sample of 595 mothers of children 6-24 months old in four low-income sections of Teresina, Piauí. We collected data on sociodemographic factors, mothers' social support, mothers' depressive symptomatology, and child's weight and recumbent length. Weight-for-height z-scores (WHZ), height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) were calculated using the National Center for Chronic Disease Prevention and Health Promotion Center SAS program based on the 2000 Centers for Disease Control reference growth curves. Multivariable linear regression was used to model the association between maternal social support and depression to child growth, adjusting for biological and socio-demographic variables. Interviewer and neighborhood variation was accounted for through the inclusion of random effects. In adjusted models, material support, measured by number of friends or family members available to mothers when needing food or milk, was related to 0.3 higher average WHZ and 0.2 higher average WAZ in their children. Maternal positive social interaction, which reflects engagement in leisure-time activities with others, was associated with 0.3 higher average WHZ. Mothers' affectionate support was related to 0.2 higher average children's WHZ and WAZ, whereas social support for resolving a conflict was associated with 0.2 lower average HAZ. Maternal depression was not associated with child growth. It is concluded that inadequate growth in children may be sensitive to maternal social support.