Background: Few studies of the effects of postnatal depression on child development have considered the chronicity of depressive symptoms. We investigated whether early postnatal depressive symptoms (PNDS) predicted child developmental outcome independently of later maternal depressive symptoms.Methods: In a prospective, longitudinal study, mothers and children were followed-up from birth to 2 years; repeated measures of PNDS were made using the Edinburgh Postnatal Depression Scale (EPDS); child development was assessed using the Bayley Scales II. Multilevel modelling techniques were used to examine the association between 6 week PNDS, and child development, taking subsequent depressive symptoms into account.Results: Children of mothers with 6 week PNDS were significantly more likely than children of non-symptomatic mothers to have poor cognitive outcome; however, this association was reduced to trend level when adjusted for later maternal depressive symptoms.Conclusion: Effects of early PNDS on infant development may be partly explained by subsequent depressive symptoms.

Background: Pregnant women are vulnerable to the deleterious impact of environmental stressors. The aims were to identify the environmental and pregnancy characteristics independently associated with prenatal psychological distress and access to mental health care.Methods: We used data from the French cohort Étude Longitudinale Française depuis l’Enfance (ELFE), a nationally representative cohort of children followed-up from birth to adulthood. Information about prenatal psychological status and access to mental health care was collected during the maternity stay. Maternal/pregnancy characteristics independently associated with psychological distress and access to mental health care were explored using multivariate analyses.Results: Of the 15,143 mothers included, 12.6% reported prenatal psychological distress. Prenatal distress was more frequent in women with very low economical status, alcohol/tobacco use, unplanned/unwanted pregnancy, late pregnancy declaration, multiparity and complicated pregnancy (high number of prenatal visits, prenatal diagnosis examination, obstetrical complications). Of the women reporting prenatal distress, 25% had a prenatal consultation with a mental health specialist and 11% used psychotropic drugs during pregnancy. Decreased likelihood to consult a mental health specialist was found in young women, with intermediate educational level and born abroad.Limitations: Causal inferences should be made cautiously as the questionnaire did not collect information on the temporal sequence between psychological distress and associated characteristics.Conclusions: Women with social and obstetrical vulnerabilities are at increased risk of poor mental health during pregnancy. Improving mental health care access during pregnancy is a public health priority.

To assess whether prenatal exposure to 4 major classes of psychotropic drugs compared with no exposure differed with respect to neonatal outcome. We used the database collected from 13 mother-baby units (MBUs) by the French Network of MBUs. The Marcé Clinical Checklist was used to collect data from maternal interview and clinical record with respect to maternal demographic and clinical characteristics, prenatal exposure to psychotropic drugs, and neonatal outcome (birth weight, preterm birth, neonatal hospitalization). Multivariate logistic regression was used to explore the independent impact of each therapeutic class of psychotropic drug (antipsychotics, antidepressants, mood stabilizers, and anxiolytics/hypnotics) on infant outcomes. All the models were adjusted for maternal confounding factors. The sample included 1,071 women and their infants. Nearly half (40.2%) used at least 1 psychotropic drug during pregnancy. The risk of low birth weight was increased by antenatal exposure to mood stabilizers (adjusted odds ratio [aOR] = 2.04, 95% confidence interval [CI] = 1.03-4.04, P = .04). The risk of neonatal hospitalization was increased by prenatal exposure to antipsychotics (aOR = 1.74, 95% CI = 1.19-2.54, P = .004), antidepressants (aOR = 1.59, 95% CI = 1.05-2.41, P = .03) or anxiolytics/hypnotics (aOR = 1.89, 95% CI = 1.30-2.75, P = .001), independent of birth weight and term delivery status. Infants exposed to psychotropic drugs during pregnancy have less optimal neonatal outcome than unexposed infants and should be considered as a high-risk population.