New analysis from a Singapore study has found that positive and negative maternal mental health during pregnancy may influence children’s risk of developing depressive symptoms in later childhood through distinct developmental pathways, an official news release said.
Representational image of mother-child bonding. Photo courtesy: Jonathan Borba/ Unsplash
The study, published in Psychological Medicine, was led by researchers from the ASTAR Institute for Human Development and Potential (ASTAR IHDP) and Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), in collaboration with the KK Women’s and Children’s Hospital (KKH) and National University Health System (NUHS).
It drew on data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort, which is a longitudinal study tracking over 1,200 Singaporean mothers and their children from pregnancy through childhood.
Analysing data from 523 mother-child pairs, the researchers examined how maternal mental health during pregnancy was linked to children’s early cognitive development and, in turn, to later depressive symptoms. Language ability at age 2, executive function at age 7 and depressive symptoms at age 8 were examined.
Positive and negative maternal mental health shape different pathways
The study identified two distinct pathways:
● Positive maternal mental health — such as emotional wellbeing and resilience — was linked to stronger language development in early childhood, which in turn was associated with fewer depressive symptoms as children grew older.
● Negative maternal mental health — such as anxiety or depressive symptoms during pregnancy — was linked to weaker executive function in children. Executive function refers to a set of skills that help children manage their thoughts and behaviour, such as focusing attention, controlling impulses, and adapting to new situations. Poorer executive function, in turn, was associated with higher levels of depressive symptoms later in childhood.
Dr Huang Pei, senior scientist at A*STAR IHDP. Photo courtesy: A Star
“Positive and negative maternal mental health are often treated as opposite ends of a single spectrum, but our findings suggest they may represent two distinct dimensions of a mother’s mental state. Positive maternal mental health is not simply the absence of distress. A mother may experience low stress without necessarily having strong wellbeing or resilience,” said Dr Huang Pei, senior scientist at A*STAR IHDP and lead author of the study.
“Importantly, our findings show that positive and negative maternal mental health actively influences a child’s development through distinct pathways,” Pei added.
The study suggests that children’s risk of depression may begin to take shape early in life, through different developmental pathways linked to maternal mental health.
Broadening how maternal mental health is understood
This study also addresses a gap in how maternal mental health has traditionally been studied.
Dr Tan Ai Peng, principal scientist at A*STAR IHDP, and Assistant Professor at Department of Diagnostic Radiology at NUS Medicine. Photo courtesy: A Star
Maternal mental health is known to strongly influence child development and long-term mental health outcomes. However, most existing research has focused primarily on negative maternal mental health, with less attention given to positive aspects such as emotional wellbeing and resilience.
By examining both positive and negative dimensions together, this study provides a more complete picture of how maternal mental health may shape child development.
“Most research on maternal mental health has focused on reducing distress, such as anxiety, depression and stress. What this study adds is evidence that instilling positivity may be just as important as reducing distress. Promoting positive wellbeing during pregnancy appears to play a distinct role in shaping child development and may influence children differently from negative mental health. That distinction could have real implications for how we think about supporting mothers,” said Dr Tan Ai Peng, principal scientist at A*STAR IHDP, Assistant Professor at Department of Diagnostic Radiology at NUS Medicine and senior author of the study.
Distinct roles of language and executive function
To understand how the effects of positive and negative maternal mental health unfold over time, the researchers examined two key areas of early cognitive development: language ability and executive function. Stronger language skills were associated with a lower risk of depressive symptoms, while weaker executive function was associated with higher vulnerability.
These two areas of development were examined because of the central role they play in how children understand, process and respond to their experiences. Early language skills support a child’s ability to express emotions, communicate needs and engage with others, supporting social relationships and adapting to difficult experiences. Executive function, on the other hand, supports self-control, emotional regulation and cognitive flexibility, reflecting the child’s ability to cope with stress and regulate negative emotions.
Differences in these abilities may shape how children respond to their environment over time, influencing their emotional resilience and risk of developing depressive symptoms later in childhood.
Implications for earlier understanding and support
Language ability and executive function continue to develop throughout childhood and can be strengthened through supportive environments and targeted interventions, representing valuable opportunities for early support.
“By the time a child shows signs of depression, the developmental pathways leading there may already have been set in place years earlier. This study helps us trace those early pathways back to pregnancy and early childhood. While there is still much to learn, the findings point to opportunities to better support both mothers and children at earlier stages,” added Pei.
The researchers emphasised that maternal mental health does not determine a child’s later outcomes. Rather, it is one of many factors that may contribute to a child’s development over time.
“These findings reinforce the need for a more comprehensive approach to maternal and child mental health. This means identifying and treating maternal distress as early as possible, while also actively promoting positive wellbeing during pregnancy. At the same time, supporting children’s language and executive function development may help strengthen the early foundations of emotional health,” said Peng.
