Prenatal-postnatal maternal anxiety mismatch, maternal stroking, child irritability and general psychopathology ‘p’ at age 7 years; findings from the Wirral Child Health and Development Study

BackgroundAccording to fetal origins hypotheses, mismatched prenatal-postnatal conditions will be associated with poor health outcomes. Based on previous findings from the Wirral Child Health and Development Study (WCHADS) that associations between prenatal anxiety and child anxious- depressed symptoms were modified by mothers’ reports of infant stroking, we predicted similar effects following mismatched prenatal-postnatal maternal anxiety. Low stroking would be associated with poorer outcome. In view of associations between oppositional defiant disorder (ODD) irritability and adolescent depression, our models predicted irritability, controlling for general psychopathology ‘p’, and contrasted with headstrong, to test for specificity. Based on animal and human evidence we predicted that the effect would be seen only in girls.MethodsMothers in the WCHADS, a general population cohort recruited at 20 weeks pregnancy, provided self- reported anxiety during pregnancy, and at 9 weeks, 14 months and 3.5 years postpartum, frequency of infant stroking at 9 weeks. Mothers and teachers reported child symptoms at age 7 years. Irritability scores were available from 668 children, and SEM models with maximum-likelihood estimates made use of data from 887 participants. ResultsThere was a three way interaction between prenatal and postnatal anxiety and maternal stroking. This arose because lower stroking at 9 weeks was associated with higher irritability at 7 years, only in the mismatched, low-high and high-low maternal anxiety groups. The effect was unchanged after accounting for associations with general psychopathology, ‘p’. There was no effect on headstrong symptoms. Despite an overall effect on irritability in separate analyses this was confined to girls. ConclusionsPostnatal modifications of prenatal effects of maternal anxiety were specific to child irritability, and seen only in girls. Given associations between child irritability and adolescent depression, the findings provide further indications of mechanisms for fetal and postnatal origins of affective disorders in adolescence and beyond.