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Maternal depression symptoms, unhealthy diet and child emotional–behavioural dysregulation

  • L. Pina-Camacho (a1) (a2), S. K. Jensen (a3), D. Gaysina (a4) and E. D. Barker (a3)



Maternal depression and unhealthy diet are well-known risk factors for adverse child emotional–behavioural outcomes, but their developmental relationships during the prenatal and postnatal periods are largely uncharted. This study sought to examine the inter-relationships between maternal depression symptoms and unhealthy diet (assessed during pregnancy and postnatal periods) in relation to child emotional–behavioural dysregulation (assessed at the ages of 2, 4 and 7 years).


In a large prospective birth cohort of 7814 mother–child pairs, path analysis was used to examine the independent and inter-related associations of maternal depression symptoms and unhealthy diet with child dysregulation.


Higher prenatal maternal depression symptoms were prospectively associated with higher unhealthy diet, both during pregnancy and the postnatal period, which, in turn, was associated with higher child dysregulation up to the age of 7 years. In addition, during pregnancy, higher maternal depression symptoms and unhealthy diet were each independently associated with higher child dysregulation up to the age of 7 years. These results were robust to other prenatal, perinatal and postnatal confounders (such as parity and birth complications, poverty, maternal education, etc.).


Maternal depression symptoms and unhealthy diet show important developmental associations, but are also independent risk factors for abnormal child development.


Corresponding author

* Address for correspondence: Edward D. Barker, Ph.D., Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email:


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Akbaraly T, N, Brunner, EJ, Ferrie, JE, Marmot, MG, Kivimaki, M, Singh-Manoux, A (2009). Dietary pattern and depressive symptoms in middle age. British Journal of Psychiatry 195, 408413.
Akbaraly, TN, Sabia, S, Shipley, MJ, Batty, GD, Kivimaki, M (2013). Adherence to healthy dietary guidelines and future depressive symptoms: evidence for sex differentials in the Whitehall II Study. American Journal of Clinical Nutrition 97, 419427.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Barker, ED (2013). The duration and timing of maternal depression as a moderator of the relationship between dependent interpersonal stress, contextual risk and early child dysregulation. Psychological Medicine 43, 15871596.
Barker, ED, Copeland, W, Maughan, B, Jaffee, SR, Uher, R (2012). Relative impact of maternal depression and associated risk factors on offspring psychopathology. British Journal of Psychiatry 200, 124129.
Barker, ED, Kirkham, N, Ng, J, Jensen, SK (2013). Prenatal maternal depression symptoms and nutrition, and child cognitive function. British Journal of Psychiatry 203, 417421.
Bentler, PM (1990). Comparative fit indexes in structural models. Psychological Bulletin 107, 238246.
Boyd, A, Golding, J, Macleod, J, Lawlor, DA, Fraser, A, Henderson, J, Molloy, L, Ness, A, Ring, S, Davey Smith, G (2013). Cohort profile: the ‘Children of the 90s’ – the index offspring of the Avon Longitudinal Study of Parents and Children. International Journal of Epidemiology 42, 111127.
Braveman, P, Marchi, K, Egerter, S, Kim, S, Metzler, M, Stancil, T, Libet, M (2010). Poverty, near-poverty, and hardship around the time of pregnancy. Maternal and Child Health Journal 14, 2035.
Browne, MW, Cudeck, R (1993). Alternative ways of assessing model fit. In Testing Structural Equation Models (ed. Bollen, K. A. and Long, J. S.), pp. 230258. Sage: Newbury Park, CA.
Campbell, SB, Matestic, P, von Stauffenberg, C, Mohan, R, Kirchner, T (2007). Trajectories of maternal depressive symptoms, maternal sensitivity, and children's functioning at school entry. Developmental Psychology 43, 12021215.
Carey, WB, McDevitt, SC (1978). Revision of the Infant Temperament Questionnaire. Pediatrics 61, 735739.
Cox, JL, Holden, JM, Sagovsky, R (1987). Detection of postnatal depression: the development of the Edinburgh 10-item Postnatal Depression Scale. British Journal of Psychiatry 150, 782786.
Elam, KK, Harold, GT, Neiderhiser, JM, Reiss, D, Shaw, DS, Natsuaki, MN, Gaysina, D, Barrett, D, Leve, LD (2014). Adoptive parent hostility and children's peer behavior problems: examining the role of genetically informed child attributes on adoptive parent behavior. Developmental Psychology 50, 15431552.
Fraser, A, Macdonald-Wallis, C, Tilling, K, Boyd, A, Golding, J, Davey Smith, G, Henderson, J, Macleod, J, Molloy, L, Ness, A, Ring, S, Nelson, SM, Lawlor, DA (2013). Cohort profile: the Avon Longitudinal Study of Parents and Children: ALSPAC mothers cohort. International Journal of Epidemiology 42, 97110.
Glover, V, O'Connor, TG, O'Donnell, K (2010). Prenatal stress and the programming of the HPA axis. Neuroscience and Biobehavioral Reviews 35, 1722.
Goodman, R (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 40, 13371345.
Goodman, SH, Gotlib, IH (1999). Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychological Review 106, 458490.
Goodman, SH, Rouse, MH, Connell, AM, Broth, MR, Hall, CM, Heyward, D (2011). Maternal depression and child psychopathology: a meta-analytic review. Clinical Child and Family Psychology Review 14, 127.
Gow, RV, Vallee-Tourangeau, F, Crawford, MA, Taylor, E, Ghebremeskel, K, Bueno, AA, Hibbeln, JR, Sumich, A, Rubia, K (2013). Omega-3 fatty acids are inversely related to callous and unemotional traits in adolescent boys with attention deficit hyperactivity disorder. Prostaglandins, Leukotrienes and Essential Fatty Acids 88, 411418.
Hiza, HA, Casavale, KO, Guenther, PM, Davis, CA (2013). Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level. Journal of the Academy of Nutrition and Dietetics 113, 297306.
Hurley, KM, Caulfield, LE, Sacco, LM, Costigan, KA, Dipietro, JA (2005). Psychosocial influences in dietary patterns during pregnancy. Journal of the American Dietetic Association 105, 963966.
Jacka, FN, Ystrom, E, Brantsaeter, AL, Karevold, E, Roth, C, Haugen, M, Meltzer, HM, Schjolberg, S, Berk, M (2013). Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study. Journal of the American Academy of Child and Adolescent Psychiatry 52, 10381047.
Jensen, SK, Dumontheil, I, Barker, ED (2014). Developmental inter-relations between early maternal depression, contextual risks, and interpersonal stress, and their effect on later child cognitive functioning. Depression and Anxiety 31, 599607.
Little, RJA, Rubin, DB (2002). Statistical Analysis with Missing Data, 2nd edn. Wiley: New York.
Liu, J, Raine, A, Venables, PH, Mednick, SA (2004). Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years. American Journal of Psychiatry 161, 20052013.
Monk, C, Georgieff, MK, Osterholm, EA (2013). Research review: maternal prenatal distress and poor nutrition – mutually influencing risk factors affecting infant neurocognitive development. Journal of Child Psychology and Psychiatry 54, 115130.
Moshfegh, AJ (2007). Research to advance understanding of the interrelationship of poverty and nutrition. Journal of the American Dietetic Association 107, 18821885.
Murray, L, Carothers, A (1990). The validation of the Edinburgh Post-natal Depression Scale on a community sample. British Journal of Psychiatry 157, 288290.
Muthén, LK, Muthén, BO (1998–2013). Mplus. Statistical Analyses with Latent Variables. User's Guide. Muthén & Muthén: Los Angeles, CA.
Nyaradi, A, Li, J, Hickling, S, Foster, J, Oddy, WH (2013). The role of nutrition in children's neurocognitive development, from pregnancy through childhood. Frontiers in Human Neuroscience 7, 97.
Office of Population Censuses and Surveys (1991). Standard Occupational Classification, vol. 3. HMSO: London.
Pachter, LM, Auinger, P, Palmer, R, Weitzman, M (2006). Do parenting and the home environment, maternal depression, neighborhood, and chronic poverty affect child behavioral problems differently in different racial–ethnic groups? Pediatrics 117, 13291338.
Raine, A, Mellingen, K, Liu, J, Venables, P, Mednick, SA (2003). Effects of environmental enrichment at ages 3–5 years on schizotypal personality and antisocial behavior at ages 17 and 23 years. American Journal of Psychiatry 160, 16271635.
Rao, TS, Asha, MR, Ramesh, BN, Rao, KS (2008). Understanding nutrition, depression and mental illnesses. Indian Journal of Psychiatry 50, 7782.
Rechenberg, K, Humphries, D (2013). Nutritional interventions in depression and perinatal depression. Yale Journal of Biology and Medicine 86, 127137.
Rogers, I, Emmett, P (1998). Diet during pregnancy in a population of pregnant women in South West England. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. European Journal of Clinical Nutrition 52, 246250.
Scott, D, Happell, B (2011). The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues in Mental Health Nursing 32, 589597.
Silberg, J, Rutter, M (2002). Nature–nurture interplay in the risks associated with parental depression. In Children of Depressed Parents: Mechanisms of Risk and Implications for Treatment (ed. Goodman, S. H. and Gotlib, I. H.), pp. 1336. American Psychological Association: Washington, DC.
Sullivan, EL, Grayson, B, Takahashi, D, Robertson, N, Maier, A, Bethea, CL, Smith, MS, Coleman, K, Grove, KL (2010). Chronic consumption of a high-fat diet during pregnancy causes perturbations in the serotonergic system and increased anxiety-like behavior in nonhuman primate offspring. Journal of Neuroscience 30, 38263830.
Vucetic, Z, Kimmel, J, Totoki, K, Hollenbeck, E, Reyes, TM (2010). Maternal high-fat diet alters methylation and gene expression of dopamine and opioid-related genes. Endocrinology 151, 47564764.
Weinstock, M (2008). The long-term behavioural consequences of prenatal stress. Neuroscience and Biobehavioral Reviews 32, 10731086.
Wu, A, Molteni, R, Ying, Z, Gomez-Pinilla, F (2003). A saturated-fat diet aggravates the outcome of traumatic brain injury on hippocampal plasticity and cognitive function by reducing brain-derived neurotrophic factor. Neuroscience 119, 365375.


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Maternal depression symptoms, unhealthy diet and child emotional–behavioural dysregulation

  • L. Pina-Camacho (a1) (a2), S. K. Jensen (a3), D. Gaysina (a4) and E. D. Barker (a3)


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