Prenatal and postnatal psychological symptoms of parents and family functioning: the impact on child emotional and behavioural problems

Although relations of various parental psychological problems and family functioning with child development are well documented, it remains unclear whether specific prenatal or specific postnatal risk factors are independently associated with child emotional and behavioural problems, or whether observed associations can be explained by general parental psychopathology. Using a stepwise approach, we examined the effects of prenatal and postnatal parental depressive symptoms, prenatal and postnatal hostility of the parents, as well as prenatal family functioning on the risk of child emotional and behavioural problems. This study was embedded in Generation R: a population-based cohort from foetal life onwards. Mothers and fathers of 2,698 children provided information about depressive symptoms, symptoms of hostility and family functioning during pregnancy and 3 years after birth. Mother and father each reported on child behaviour when the child was 3 years old. Parental depressive symptoms increased the risk of child emotional and behavioural problems, but this increase was explained by postnatal parental hostile behaviour. Postnatal symptoms of hostility of mothers (OR = 1.34, p value <0.001) and postnatal symptoms of hostility of fathers (OR = 1.30, p value <0.001) each contributed independently to the risk of child emotional and behavioural problems. Postnatal parental hostility is associated with an increased risk of child emotional and behavioural problems, independent of parental depressive symptoms. These findings suggest that prevention and intervention strategies should focus on psychological symptoms of both mothers and fathers, in particular on hostile behaviour, in families with young children

Sample characteristics by <i>FTO</i> rs9939609 genotype (n = 1718).

a<p>mean (standard deviation) unless otherwise indicated.</p>b<p>median (100% range).</p>c<p>with the chi-square statistic for categorical variables, one-way ANOVA for normally distributed continuous variables and the Kruskal-Wallis test for non-normally distributed.</p><p>continuous variables.</p>d<p>overweight or obesity is defined as a BMI-sds >1.10.</p

Associations of child <i>FTO</i> at rs9939609 with child executive function at 4 years.

<p>Abbreviations: OR, odds ratio; 95%CI, 95% confidence interval; ref, reference.</p>a<p>The ORs represent the increased risk of clinical scores on BRIEF-P Emotional Control and Inhibition per <i>FTO</i> minor allele at rs9939609.</p

Correlation between child BMI, child emotional and behavioural problems, executive function and eating behaviour.

<p>Spearman correlation coefficient (two tailed).</p>*<p><0.05, **<0.01 ***<0.001.</p

Associations of child <i>FTO</i> at rs9939609 with child eating behaviour at 4 years (n = 1718).

<p>Abbreviations: OR, odds ratio; 95%CI, 95% confidence interval; ref, reference.</p>a<p>The ORs represent the increased risk of high scores on CEBQ subscales per <i>FTO</i> minor allele at rs9939609.</p

Variation in the glucocorticoid receptor gene at rs41423247 moderates the effect of prenatal maternal psychological symptoms on child cortisol reactivity and behavior

Prenatal maternal psychopathology affects child development, but some children seem more vulnerable than others. Genetic variance in hypothalamic-pituitary-adrenal axis genes may influence the effect of prenatal maternal psychological symptoms on child emotional and behavioral problems. This hypothesis was tested in the Generation R Study, a population-based cohort from fetal life onward. In total, 1727 children of Northern European descent and their mothers participated in this study and were genotyped for variants in the glucocorticoid receptor (GR) gene (rs6189/rs6190, rs10052957, rs41423247, rs6195, and rs6198) and the FK506-binding protein 5 (FKBP5) gene (rs1360780). Prenatal maternal psychological symptoms were assessed at 20 weeks pregnancy and child behavior was assessed by both parents at 3 years. In a subsample of 331 children, data about cortisol reactivity were available. Based on power calculations, only those genetic variants with sufficient minor allele frequencies (rs41423247, rs10052957, and rs1360780) were included in the interaction analyses. We found that variation in GR at rs41423247 moderates the effect of prenatal maternal psychological symptoms on child emotional and behavioral problems (beta 0.41, SE 0.16, p0.009). This prenatal interaction effect was independent of mother's genotype and maternal postnatal psychopathology, and not found for prenatal psychological symptoms of the father. Moreover, the interaction between rs41423247 and prenatal psychological symptoms was also associated with decreased child cortisol reactivity (beta 2.30, p-value 0.05). These findings emphasize the potential effect of prenatal gene-environment interaction, and give insight in possible mechanisms accounting for children's individual vulnerability to develop emotional and behavioral problems