Maternal psychosocial well-being from pregnancy to five years postpartum and early development in daughters: Evidence from the 'Grandmothers, Mothers, and Their Children’s Health' study

Introduction: Maternal psychosocial conditions may influence child development beyond the first 1000 days, yet evidence integrating multiple psychological and social conditions across maternal life stages remains limited. We examined maternal psychosocial conditions across the perinatal period and 3 and 5 years postpartum and their associations with emotional–behavioural and developmental outcomes in girls.

Methods: The data included 1,797 mother–daughter dyads from the 'Grandmothers, Mothers, and Their Children’s Health' (GMATCH) study in China. Maternal depression, anxiety, loneliness, and social isolation were assessed for the perinatal period and at 3 and 5 years postpartum. At the 5-year follow-up, girls’ emotional–behavioural difficulties and developmental performance were assessed using the Strengths and Difficulties Questionnaire and Early Human Capability Index. Associations were examined using condition-specific patterns across the three assessed periods and joint psychosocial risk groups based on latent class classifications. Adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: The prevalence of any maternal psychosocial condition ranged from 24.8% to 32.3% across the three assessed periods. Overall, 6.2% of girls experienced emotional–behavioural difficulties, and the mean eHCI score was 0.80 (SD=0.09). Maternal psychosocial conditions across the assessed periods were associated with girls’ outcomes. Mothers who screened positive for psychosocial conditions at all three periods had higher odds of having daughters with emotional–behavioural difficulties (OR=7.29, 95% CI: 3.95–13.50) and low developmental performance (OR=2.56, 95% CI: 1.72–3.81). Similarly, the consistently high joint psychosocial risk group had the highest odds of emotional–behavioural difficulties (OR=8.73, 95% CI: 3.80–20.10).

Conclusions: Maternal psychosocial conditions identified across multiple periods from the perinatal stage to 5 years postpartum were associated with adverse emotional–behavioural and developmental outcomes in girls. Continued attention to maternal psychological and social well-being beyond the perinatal period may be important for child development.