Affect Disord. 2023 May 7;335:1-9. doi: 10.1016/j.jad.2023.05.003. Online ahead of print.

Gemma Sawyer ¹, Jon Heron ², Carol Joinson ³

Author information

¹MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: gemma.sawyer@bristol.ac.uk.

²MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

³Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Abstract

Background: There is evidence for an association between maternal psychopathology and offspring incontinence and constipation, but it is unclear if there is a critical/sensitive period of exposure to maternal depression and/or anxiety in the antenatal or postnatal period.

Methods: Mothers from the Avon Longitudinal Study of Parents and Children provided data on their depression and anxiety (antenatal and postnatal) and their child's urinary and faecal incontinence and constipation at age 7 (6489 participants). We used multivariable logistic regression to examine evidence for independent effects of maternal depression/anxiety on offspring incontinence/constipation and to investigate if there was a critical/sensitive period of exposure. We examined evidence for causal intra-uterine effects using a negative control design.

Results: Postnatal maternal psychopathology was associated with an increased risk of offspring incontinence and constipation (e.g. postnatal anxiety and daytime wetting OR: 1.53; 95 % CI: 1.21-1.94). Data were consistent with a postnatal critical period model and there was evidence for an independent effect of maternal anxiety. Antenatal maternal psychopathology was associated with offspring constipation (e.g. antenatal anxiety OR: 1.57; 95 % CI: 1.25-1.98), but there was no evidence for a causal intra-uterine effect.

Limitations: Attrition and maternal reports without use of diagnostic criteria for incontinence/constipation are potential limitations.

Conclusions: Children exposed to maternal postnatal psychopathology had a greater risk of incontinence/constipation, and maternal anxiety had stronger associations than depression. Health professionals should be vigilant to effects of maternal psychopathology on child development. Identification of mechanisms linking maternal psychopathology to child incontinence/constipation is required to inform evidence-based support.