Postpartum Depression and Child Development in the First Two years: a Nationwide Population-Based Study in Israel

Background: Postpartum depression is the most common complication women experience after delivery. The relatively high prevalence of postpartum depression reinforces the need for better understanding of maternal depression impact on child development.

Objective: To study the association between suspected postpartum depression (PPD) and child development by developmental milestones in the first two years of life.

Study design and Methods: A population-based historical cohort study in the setting of a national program for screening for PPD. The study included 90,872 mothers who gave birth in 2014-2015 and responded to the Edinburgh Postpartum Depression Scale (EPDS) questionnaire. Data collected included follow up for developmental domains of gross and fine motor, personal-social skills and language skills up to 24 months. Logistic regressions were used to compare the incidence of developmental delays between infants of positive (EPDS+) and non-positive (EPDS-) women, controlling for potential confounders.

Results: The overall prevalence of EPDS+ was 4.7% (n=4,268(. Significant associations were found between PPD and developmental delays in language skills including the production of voices in dialogue (adjusted OR=1.86, 95% CI: 1.39-2.49). PPD was associated with 1.5 increased odds of delays in personal-social skills, including social smile and pointing to selected objects. Associations were also seen with delays in fine motor and adaptive skills, such as pinching (OR=1.47, 95% CI: 1.18-1.83), and gross motor skills, such as ground crawl (adjusted OR=1.35, 95% CI: 1.14-1.59).

Conclusions: In this population-based large scale study, maternal symptoms of PPD were associated with early child neurodevelopment. Specific interventions should be developed for this early stage for the prevention of developmental gaps.