Maternal prenatal stress and postnatal depressive symptoms: discrepancy between mother and teacher reports of toddler psychological problems

Soc Psychiatry Psychiatr Epidemiol. 2021 Apr;56(4):559-570. doi: 10.1007/s00127-020-01964-z. Epub 2020 Sep 29.


Purpose: Maternal prenatal stress and postnatal depression are reported to increase the risk for early offspring psychological problems. We examined whether these two stressors predicted toddler emotional or behavioral problems based on the mother and teacher reports, respectively.

Methods: A longitudinal study within the Odense Child Cohort (OCC). Prenatal stress was assessed (gestation week 28) using Cohen's Perceived Stress Scale (PSS). Depressive symptoms were assessed (3 months after birth) using the Edinburgh Postnatal Depression Scale (EPDS). Behavioral and emotional problems were assessed by mothers using the preschool version of Child Behaviour Checklist (CBCL) and by teachers using the caregiver-teacher report form (CTR-F).

Results: N = 1302 mother-child dyads were included. CBCL (N = 1302) was collected at 29 months (SD 5.3) and C-TRF (N = 989) at 32.6 months (SD 6.9). N = 70 mothers (5.4%) were at high risk for postnatal depression (EPDS score > 12). Generalized additive models showed that prenatal stress (increase of + 1 on PSS-10 total score) predicted an increase in CBCL (+ 0.011) and C-TRF (+ 0.015) total scores. Postnatal depressive symptoms (increase of + 1 on EPDS total score) only predicted an increase in CBCL total score (+ 0.026).

Conclusion: Prenatal maternal stress was a significant predictor of both mother and teacher reported toddler emotional and behavioral problems, although effect sizes were small. Postnatal depressive symptoms were associated with increased maternal (but not teacher) reporting of toddler problems. Mothers reported more toddler psychological problems than teachers, and the mother-teacher discrepancy was positively correlated to maternal postnatal depressive symptoms.

Keywords: Child development; Developmental epidemiology; Fetal programming; Mother-teacher disagreement; Postnatal depression.

MeSH terms

  • Child, Preschool
  • Depression
  • Depression, Postpartum* / diagnosis
  • Depression, Postpartum* / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Mothers*
  • Pregnancy
  • Psychiatric Status Rating Scales