Trajectory of maternal perinatal negative psychological states and its association with early offspring neurodevelopment: A longitudinal cohort study

Background Existing studies often examined single psychological states in isolation (depression, anxiety, stress) or used static assessments, limiting the understanding of dynamic trajectories and synergistic effects of co-occurring psychological states. The study was designed to tackle both major limitations.Methods 609 pregnant women in their third trimester were enrolled. Maternal depression, anxiety, and perceived stress were repeatedly assessed at the third trimester and 1, 3, and 6 months postpartum using the Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder 7-item scale, and Perceived Stress Scale. Infant neurodevelopment was evaluated at the same postpartum timepoints using the Ages and Stages Questionnaire-Third Edition. Group-based multi-trajectory modeling (GBMTM) was used to identify joint developmental trajectories of three negative psychological states, and multilevel models assessed their association with neurodevelopmental outcomes. Growth mixture modeling was applied to identify independent trajectories for each psychological state.Results A total of 417 mother-infant dyads completed the longitudinal follow-up. The GBMTM identified three distinct trajectories: Stable Low Negative Psychological State Group (29.9%), Stable Moderate Negative Psychological State Group (55.2%), and Unstable High Negative Psychological State Group (14.8%). After adjusting for confounders, maternal negative psychological states were significantly correlated with poorer offspring neurodevelopment, including communication, gross motor, fine motor, problem solving, personal-social skills. Stratified analysis revealed sex-specific effects of negative psychological states.Conclusion Maternal perinatal negative psychological states were significant risk factors for adverse early infant neurodevelopment. These findings highlight the importance of screening for and addressing co-occurring maternal negative psychological states during perinatal period.