Modifying the Impact of Maternal Psychopathology on Adverse Infant Health Outcomes---Effects of Paternal Involvement and a Trial on Positive Activity Intervention

Maternal depression during prenatal and postpartum periods affects maternal health and predicts disturbances in children’s later social, behavioral, cognitive, and physical development. However, previous studies in Taiwan are limited in longitudinally following up a cohort of women, together with their partner, from early pregnancy and investigating the effects of parental psychological disturbances in children’s developmental outcomes within the first three critical years. Current literature further notably understudies the role of paternal involvement in child caretaking and the effects of positive activity intervention on ameliorating perinatal depressive symptoms and its consequences. Thus, our study is aimed at investigating the negative impact of maternal perinatal depression on children’s growth and development within the first three years. Two factors are proposed to evaluate the changing effects, including (1) the evaluation of the modifying effects of paternal involvement (as paternal highly involving in caretaking and functioning might yield protective effects); and (2) the evaluation of the effects of a randomized trial on positive activity intervention in ameliorating maternal depression and its consequences on promoting child development. In this prospective cohort study design, 2 cohorts are accommodated. Cohort I (about 430 pairs) includes those who joined our previous study and were followed up from the first trimester of pregnancy till six months postpartum. These couples will be invited to this new study and continued following-up both parental psychopathology and child’s developmental outcomes till 3 years after childbirth. Three assessments (when the child is 1, 2, and 3 years old) will be scheduled. Cohort II (about 430 pairs) will recruit new couples in two medical centers and two regional hospitals in Taipei metropolitan area. All pregnant women who undergo a first-trimester prenatal visit, who plan to carry the baby till term, and whose partner is also willing to participate will be invited to join our study. Seven assessments (at three trimesters, and 1 month, 6 months, 1 year, and 2 years postpartum) will be scheduled. Self-reported questionnaires will be basically filled out in the hospitals. For mothers in Cohort II at each assessment, the Edinburgh Postnatal Depression Scale will be performed for depression screening. Women with scores higher than 12 (high level of depression, about 86 women) will be invited and randomly assigned to one of the two groups (“positive activity intervention” and “regular care comparison group”) in a randomized trial. These women will be followed-up, with four assessments on their mental health being performed within six months after the intervention for effects estimation. After data are collected, descriptive, analytic and longitudinal data analyses will be performed for analysis. This study will explore the effects of maternal depression on infant/toddler development during the critical perinatal years. The effectiveness and feasibility of the proposed model will be well monitored and evaluated. It is hoped that our findings on effectiveness of high paternal involvement and positive activity intervention may provide significant contribution in promoting parental health and consequently boosting child’s healthy growth and development.