Postpartum Mental Health and Infant Development During the COVID-19 Pandemic

Background: Infection mitigation strategies implemented during the COVID-19 pandemic influenced social experiences for new mothers and their infants, with potential to negatively impact infant development. Early reports during the pandemic show postpartum women have increased rates of anxiety and depression which are known risk factors for developmental delay. Additionally, stay-at-home orders, social distancing, and use of face masks may alter visual input (facial expressions and oral motor movements) infants receive with the potential to negatively impact social-emotional and communication development. Thus, there is need to examine the developmental trajectory of infants born during the COVID-19 pandemic. We hypothesized that higher COVID impact and maternal symptoms of anxiety and depression would be linked to greater risk for developmental delay.

Methods: We recruited 125 first-time mothers of infants less than 3 months of age from four pediatric primary care offices in Pennsylvania and Delaware (June 2020 - February 2021). Mothers completed a self-report interview when their infants were less than 3 months of age (baseline) and again at 6 months of age (follow-up), asking about COVID-19 family impact, anxiety and depression symptoms (EPDS Total, Anxiety, Depression), infant development (ASQ-3 at 3 months and 6 months and ASQ-SE at 6 months), and items inquiring about the frequency of mother-child caretaking activities across a range of behaviors.

Results: Bivariate correlations found that while perceived family impact from COVID-19 was related to maternal self-report of postpartum depression symptoms at baseline (r = .32, p = .001), it was not related to the frequency of mother-child caretaking activities or infant development in the first 6 months of life. However, hierarchical linear regression found when controlling for COVID-19 family impact, baseline postpartum depression symptoms were related to fewer concurrent mother-child caretaking activities (β =.24, p = .007) and predicted poorer infant social-emotional development at 6 months of age (β = .23, p = .013).

Conclusion: Consistent with prior literature, maternal postpartum depression symptoms were related to fewer concurrent mother-child caretaking activities and poorer infant social-emotional development at 6 months of age. However, despite anecdotal maternal concern, there was not a relationship between the effect of COVID-19 on the family unit and infant development. It is possible that COVID-19 pandemic effects will play a more prominent role as infants’ complex language and social skills emerge. However, the current findings do not support a direct effect of pandemic family impact on infant development during the first six months of life, instead underscoring the importance of maternal wellbeing and functioning for infant social-emotional development.