The effects of prenatal attachment level, anxiety and depression during pregnancy on infancy and early childhood:A cohort study

Aim: Prenatal attachment is the sole relationship formed between the mother and her unborn infant and it is a common concern that the negative impacts of psychiatric morbidities like anxiety and depression during pregnancy might also consider prenatal attachment, resulting in much adverse consequences. Prenatal attachment and the development during infancy and early childhood, emotional and behavioral characteristics and the relationship with parental attitudes is a field left mainly understudied. The aim of this research that was designed as a cohort study was to assess the effects of prenatal attachment levels during pregnancy, depression and anxiety on the duration of breastfeeding, social and emotional wellbeing during infancy and early childhood (12-36 months), development and parental attitudes during this identified phase. Method: Our study sample consisted of 142 mothers and their infants currently aged between 12-36 months that have applied to Dokuz Eylul University Medical School Gyneacology and Obstetrics Department for routine obstetric evaluation during the prenatal 28-40 week period between dates June 2012 and Deecember 2012 who have agreed to participate voluntarily in our study. Mothers were given sociodemographic data form, Beck Depression Invantory, Beck Anxiety Invantory, Parental Attitude Research Instrument and Brief Infant and Toddler Social Emotional Assessment. Ankara Development Screening Inventory to elavuate the developmental levels of children were also applied. Results: The mothers who have scored higher in the depression scale during the prenatal period scored higher also during the time of the study for depression and it was also observed that the depression scores increased for these mothers during the time of the study compared to the prenatal period. Mothers who have scored higher in the anxiety scale during prenatal period continued to score higher in anxiety scales during the time of the study; but it was seen that there was a decline in anxiety scores during the time of the study when compared to the anxiety scores obtained during the prenatal period. The infants of the mothers who scored higher in the depression scale during the time of the study and had a higher discrepancy regarding depression scores during prenatal period and the time of the study had a lower T score in Ankara Development Screening Inventory (AGTE); the infants of mothers who had an increased depression level compared to prenatal period had a lower AGTE T score. The infants of the mothers who had a higher level of prenatal attachment scored higher in both AGTE T scores and Brief Infant and Toddler Social Emotional Assessment (BITSEA) competence subscale scores. The mothers who had infants with developmental delay had scored lower in prenatal attachment assessment. The mothers who had higher depression scores during the study period had also scored higher in hostility and parental rejection and marital discordance in the subscales of Parental Attitude Research Instrument (PARI). Children with higher problem scores in BITSEA scale had lower AGTE T scores. Children with higher competence scores in BITSEA scale had higher AGTE T scores. Conclusion: It was seen that prenatal attachment and maternal psychiatric well being including the presence of depression and anxiety during pregnancy had important effects on the development and emotional and behavioral competence of their infants and children. Infants of mothers who had lower prenatal attachment had a greater risk of declined emotional and behavioral competence compared to the infants of mothers with higher prenatal attachment levels around 2 years old. In addition to that, it was seen that the depression that had started during the prenatal period continued clinically even after 2 years from the onset and the development of children of these mothers were adversely affected by this situation. It was concluded that the determination of high risk groups that show an increased vulnerability regarding psychiatric disorders in particular and planning preventive measures might decrease the lifetime risk of psychopathology, resulting in a better development of community based psychiatric well being. Keywords: Prenatal attachment, prenatal depression, prenatal anxiety, social and emotional characteristics in infancy and early childhood, development, parental attitudes