The impact of postpartum depression on child development

There is evidence for an association between postpartum depression and a number of indices of adverse child outcome. In infants of mothers with postpartum depression, deficits have been found in their early interactions and their cognitive functioning. A high rate of insecure attachment is also apparent. There is also evidence for a longer term association: cognitive development in the four-year-olds of mothers who have had a postpartum depression appears compromised (at least in boys from lower socio-economic backgrounds), and there is an association with behavioural disturbance. Longitudinal analyses reveal that the impaired patterns of early interaction occurring between mother and infant in the context of the maternal mood disorder may be an important determinant of some of these adverse child outcomes. With respect to cognitive development, there is evidence of a sensitive developmental period, although its precise parameters are uncertain. Observational and experimental studies are needed to elucidate the process by which maternal and infant behaviour becomes disturbed. The explanatory potential of treatment studies has been little exploited and that of sibling studies not at all. Such enquiry could contribute much to elucidating the relative contributions of genetic and environmental factors to the association between postpartum depression and adverse child outcome.