In an article being released this week in Pediatrics (10.1542/peds.2022-056562), Bechtiger et al draw a link between the number of self-reported adolescent unhealthy behaviors and self-reported maternal depressive symptoms in a 15-year prospective-longitudinal community study of 447 participants from a community-based study in North Carolina. This project builds upon and extends cross-sectional research linking maternal depression with singular maladaptive behavior among children (article references 9-12).
The authors define unhealthy behaviors as “poor sleep, poor diet, physical inactivity, sedentary behavior, and smoking.” According to the authors, such behaviors are important to study because of their association with cardiovascular disease later in life (article references 1,2).
Examining data from children from ages 2–17-years-old, the authors sought to answer the following questions:
- Are early childhood maternal depressive symptoms associated with unhealthy behaviors in children and adolescents?
- Does timing of maternal depressive symptoms matter?
- Are maternal depressive symptoms and adolescent unhealthy behaviors also associated with child depressive symptoms & increased body mass index (BMI).
- Associations and differentiations by sex.
Approximately 6-13% of mothers reported symptoms of depression among the different child age cohorts as a whole and over two-thirds of all adolescents reported at least one unhealthy behavior. The authors observed a dose response: higher levels of depressive symptoms were associated with more unhealthy behaviors among 16–17-year-olds—particularly during their middle childhood and adolescence. This observance held even when adjusting for sociodemographic characteristics. There were no sex differences in self-reported symptoms nor was there any association with elevated BMI or childhood depressive symptoms.
The authors correctly point out the limitations of correlational and self-report data in addition to the biological link that can exist between maternal and child depressive symptoms. However, if causation can be established for these findings using a prospective longitudinal methodology and not just cross-sectional as done for this study , it would give even more reason to screen for maternal mental health wellbeing along the life course of a given patient. In other words, maternal mental health may still need to be addressed beyond the newborn/neonatal period.