Association Between Maternal Mental Health, the COVID-19 Pandemic, and Children's Developmental Outcomes in Scotland: A Linked Administrative Health Data Analysis [pre-print]

Abstract

Background: The number of reported maternal mental health (MH) difficulties during the COVID-19 pandemic was higher compared with the pre-pandemic period. Findings on the link between the COVID-19 pandemic and children’s developmental outcomes suggest significantly lower scores in the Ages and Stages Questionnaire (ASQ-3). The present study explored the interaction effects of maternal MH and being born during COVID-19 on children’s developmental outcomes.

Methods: This was a retrospective cohort design using administrative datasets from Scotland. Children born between 1st March 2020 and 30th June 2021, inclusive (n=32,683), and a comparative historical cohort that included those born between 1st April 2017 and 31st October 2018 in Scotland (n=50,257) were included. Regression models were used adjusting for covariates, with outcomes as ASQ-3 scores and developmental concerns, and predictors as MH measured by a history of hospital admission and birth during the COVID-19 pandemic.

Findings: MH was associated with increased odds of developmental concerns; (odds ratio (OR)= 1.038, 95% CI [1.012, 1.064], p=0.004**) and reduced ASQ scores SD; 0.13 (β =-0.130, 95% CI [-0.204, -0.056], p<0.001***). There were mixed findings on the association between being born during the COVID-19 pandemic (developmental concerns: OR= 1.024, 95% CI [1.019, 1.029], p<0.001***) and ASQ scores (β= 0.012, 95% CI [-0.002, 0.025], p=0.08) but no interaction between MH and birth during the COVID-19 pandemic.

Interpretation: Our findings suggest that although being born during the COVID-19 pandemic and MH influenced child development with relatively small effects, their combined presence did not exacerbate this effect. Our study only examined developmental outcomes up to age 13 – 15 months. Future studies should explore the potential long-term effects of both being born during the pandemic and MH.

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https://dx.doi.org/10.2139/ssrn.5027306