Prenatal Maternal Depressive Symptoms Predict Early Infant Health Concerns.

INTRODUCTION: Recent research suggests that health disparities among low-SES and ethnic minority populations may originate from prenatal and early life exposures. Postpartum maternal depressive symptoms have been linked to poorer infant physical health, yet prenatal depressive symptoms not been thoroughly examined in relation to infant health. METHODS: In a prospective study of low-income Mexican American mothers and their infants, women (N = 322, median age 27.23, IQR = 22.01-32.54) completed surveys during pregnancy (median gestation 39.50, IQR = 38.71-40.14 weeks) and 12 weeks after birth. We investigated (1) if prenatal depressive symptoms predicted infant physical health concerns at 12 weeks of age, (2) whether these associations occurred above and beyond concurrent depressive symptoms, and (3) if birth weight, gestational age, and breastfeeding were mediators of prenatal depression predicting subsequent infant health. RESULTS: Higher prenatal depressive symptoms were associated with more infant physical health concerns at 12 weeks (p < .001), after accounting for 12-week maternal depressive symptoms, breastfeeding, gestational age, and birth weight. Twelve-week maternal depressive symptoms were concurrently associated with more infant health concerns (p < .01). Birth weight, gestational age, and breastfeeding were not associated with maternal depression or infant health concerns. DISCUSSION: Results establish a link between prenatal depressive symptoms and an elevated risk of poor health evident shortly after birth. These findings underscore the importance of the prenatal period as a possible sensitive period for infants' health, and the need for effective interventions for depression during pregnancy to mitigate potentially teratogenic effects on the developing fetus and reduce risks for later health concerns.

Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support.

Prenatal stress can have a lasting effect on women's mental health after childbirth. The negative effects may be particularly salient in women from low income and ethnic minority backgrounds, who are at increased risk for postpartum depression. However, social support may have the potential to attenuate the negative impact of stress. The present study evaluated 269 Mexican American women (ages 18-42; 83 % Spanish-speaking; median income $10,000-$15,000) for prenatal stress (daily hassles, family stress, partner stress, and culture-specific stress) in relation to depressive symptoms 6 weeks postpartum. Prenatal social support was examined as a buffer against the impact of prenatal stress. Partner stress, family stress, and daily hassles uniquely predicted depressive symptoms. Moderate and high levels of social support attenuated risk for depression due to family stressors. Prenatal interpersonal and daily stressors negatively impact the mental health of women after birth, but social support can mitigate some of these effects. Among Mexican American pregnant women, effective interpersonal support and stress management may be associated with reduced risk for postpartum depression.

A mediational model of the impact of interparental conflict on child adjustment in a multiethnic, low-income sample.

Path analysis was used to determine whether the effects of interparental conflict on children's depression and conduct disorder are mediated by 3 dimensions of parenting: acceptance, inconsistent discipline, and hostile control. The study extends the literature by testing this mediational model with a low-income, predominantly ethnic minority sample of preadolescent children and by examining the effects of multiple dimensions of interparental conflict from the child's perspective. Results supported the mediational model when analyses were based on child's reports of all variables but not when mother's reports were used to assess child depression and conduct problems. Exploratory analyses revealed unique mediational paths associated with conflict frequency and resolution, which were examined along with intensity as distinct dimensions of interparental conflict.

Family conflict and children's internalizing and externalizing behavior: protective factors.

The current investigation examined whether the positive association of family conflict to adolescent depression and conduct problems is attenuated by maternal, paternal, and peer attachment, and maternal and paternal monitoring, within a low-income, multiethnic sample of 284 adolescents. Parental attachment and monitoring moderated the link from family conflict to conduct problems but not depression; the relationships among family conflict, the hypothesized protective factors, and conduct problems were further modified by adolescent gender but not ethnicity. In general, higher levels of the hypothesized protective factors attenuated the relationship between family conflict and conduct problems for girls but exacerbated this relationship for boys. These findings suggest that, in general, parental attachment and monitoring served as protective factors for girls while serving as additional risk factors for boys in conflictual families.

Multiple mediators of the effects of acculturation status on delinquency for Mexican American adolescents.

Research has shown that more acculturated Latino adolescents are at increased risk for delinquent behavior relative to their less acculturated counterparts. The present study examined the mediating effects of seven variables hypothesized to account for the empirical link between acculturation status and delinquent activity for a sample of Mexican American adolescents. Mediational analyses provided support for four of the putative mediators which included family conflict, maternal monitoring, inconsistent discipline, and negative peer hassles. Examined together, these variables totally mediated the effect of acculturation status on delinquent behavior. In addition, family conflict and maternal monitoring uniquely accounted for a significant proportion of the mediated variance above that explained by the other variables in the model. Adolescent's cultural identity, perceived discrimination, and maternal acceptance were not supported as mediators.

Using qualitative methods to develop contextually relevant measures and preventive interventions: an illustration.

Qualitative methods were used to develop a contextually relevant quantitative measure of parenting stress and inform the design of family-focused interventions aimed at preventing adolescent mental and behavioral health problems. The study focused on the experiences of low-income one- and two-parent families representing three ethnic groups (Mexican, African, and European Americans) living in low-income neighborhoods in a large Southwestern city. This report describes the place of this study in a broader program of prevention research, the qualitative methods and data analysis procedures employed, and how the results were used to develop a new measure of parenting stress and inform future program design. The report also includes reflective comments on the methods used and lessons gained.

Interobserver agreement in the assessment of parental behavior and parent-adolescent conflict: African American mothers, daughters, and independent observers.

Agreement between 57 African American mothers and their early adolescent daughters on measures of maternal support, maternal restrictive control, and parent-adolescent conflict were examined. To assess the relative validity of these reports, the study then evaluated them against the ratings of independent observers. Additionally, mother and daughter reports were combined to examine validity coefficients based on aggregate scores of each construct. All analyses were based on 2 sets of objective criterion ratings: ratings provided by coders of similar ethnic background (African American) and coders who were ethnically dissimilar (non-African American) to the families they rated. Overall, adolescents provided ratings that were more valid than those of their mothers when evaluated against both sets of independent ratings. Adolescent ratings of maternal control and parent-adolescent conflict converged at significantly higher levels than the ratings provided by their mothers. Maternal and adolescent reports of maternal support converged with objective criteria at statistically comparable levels. Validity coefficients for adolescent reports were also higher than those based on aggregate mother-daughter scores. Secondary analyses further revealed that African American coders rated mothers as less controlling and rated the dyadic interactions as less conflictual, and that their ratings were more consistent with the perceptions of the African American mothers and adolescents than were those provided by non-African American coders.

Family, peer, and neighborhood influences on academic achievement among African-American adolescents: one-year prospective effects.

Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American Community.