Judith van der Waerden

Background: Pregnancy represents a crucial period for understanding key pathways contributing to the intergenerational effects of adverse childhood experiences (ACEs). However, prenatal mechanisms linking maternal ACEs to subsequent child mental health outcomes are still poorly understood compared to postnatal ones. Objective: To review the biopsychosocial mechanisms during pregnancy that may contribute to the relationship between maternal ACEs and child socio‐emotional and behavioural development. Data Sources: We systematically searched PubMed, PsycInfo and Web of Science from inception up to February 2026. Study Selection and Data Extraction: We included peer‐reviewed observational studies (cohort, case–control, cross‐sectional) evaluating prenatal biological, psychological, or social mechanisms linking maternal ACEs to child socio‐emotional/behavioural outcomes (Ages 0–18); qualitative studies and grey literature were excluded. Two reviewers independently screened studies and extracted data on study design, mediators and effect sizes, with disagreements resolved by a third reviewer. Synthesis: Narrative synthesis was used to summarise study characteristics, mediation pathways and analytical strategies in tabular form. Results were synthesised by type of prenatal mechanism. Results: Of 2641 records identified, 122 full texts were assessed and 13 studies met inclusion criteria. Prenatal maternal depression and anxiety emerged as the most frequently studied mechanisms, showing some evidence of independent effects irrespective of postnatal factors, but most of the findings point towards a ‘chain‐of‐risk’ model, where prenatal mental health interacts with the postnatal environment. Biomedical antepartum risks and maternal–fetal attachment also showed mediating effects, but without accounting for postnatal influences. The small number of eligible studies underscores the limited exploration of prenatal transmission pathways. Conclusions: Prenatal mental health difficulties, particularly in interaction with postnatal factors, may play a role in the intergenerational transmission of ACEs. Further studies using robust methods to disentangle prenatal and postnatal contributions are needed to inform targeted interventions.

Background: An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance–related behaviors tend to co-occur and combine into “lifestyle patterns” (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR). Methods: Participants were children from the French nationwide ELFE ( Etude Longitudinale Française depuis l’Enfance ) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children’s energy balance-related behaviors ( n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively. Results: We identified three LPs: “Early complementary feeding, discretionary consumption, high screen time”, “Balanced diet, non-screen leisure activities”, and “Healthy feeding practices, low dairy consumption, suboptimal sleep” patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95% CI] = 1.09 [1.03, 1.16] per 1-SD increase) and inversely associated with age at AR (β [95% CI] = − 12.1 days [− 19.1; −5.0] per 1-SD increase). No association was observed for the second LP. For the third pattern, no clear evidence of associations was found, although the effect sizes were comparable to those of the first LP (OR = 1.07 [0.99; 1.15]; β = −7.6 days [− 15.5; 0.3] per 1-SD increase). Conclusion: These results emphasize the perinatal period as a critical window for the emergence of interrelated lifestyle behaviors associated with OW/OB. They highlight the need for interventional studies to evaluate the effectiveness of early, integrated, multi-behavioral strategies to prevent childhood obesity.

Paternal mental health (PMH) has been shown to associate with child development as early as infancy. However, the moderating effects of certain contextual factors remain poorly understood. Using data from the French SEPAGES cohort, an outcome‐wide analytic approach was used to investigate the relationship between PMH during pregnancy ( n = 166), 0–12 months postnatally ( n = 117), and 12–24 months postnatally ( n = 207) with child socioemotional, behavioral and cognitive outcomes at two and three years. Mother's mental health, child sex and parent's professional class were then tested as potential moderators. Findings revealed no significant associations between paternal depression or anxiety with any measure of child development. However, mother's professional class and maternal prenatal depression moderated the association between paternal anxiety and several areas of child development, with children of lower maternal professional classes showing poorer cognitive outcomes but improved social perception when exposed to paternal anxiety. Children exposed to paternal anxiety showed worse working memory outcomes and future‐oriented tasks and organization when also exposed to maternal depression. While our findings contrast with current research, showing no relationship between PMH and child development, they highlight the importance of considering family socioeconomic position when studying the relationship between PMH and child development.

THIS IS A PRE-PRINT OF AN ARTICLE PUBLISHED IN "BRAIN, BEHAVIOR, AND IMMUNITY". THE FINAL VERSION IS AVAILABLE ONLINE AT: https://doi.org/10.1016/j.bbi.2026.106780Background: Conditions associated with perinatal inflammation have been identified as risk factors for neurodevelopmental disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD). However, data linking early inflammatory biomarkers with later ADHD symptoms remain scarce. The acute phase C-reactive protein (CRP) is a key marker of systemic inflammation. To date, no studies have examined the association between CRP levels in cord blood (reflecting neonatal inflammation) and subsequent childhood ADHD symptoms. Here, we aimed to investigate whether elevated cord blood CRP concentrations are associated with child’s ADHD symptoms at age 5. Methods: We analyzed data from 1019 and 831 mother–child pairs enrolled in the ELFE and EDEN prospective birth cohorts, respectively. CRP levels in cord blood were measured using an immunoassay. ADHD symptoms were assessed at age 5 using the hyperactivity–inattention subscale of the Strengths and Difficulties Questionnaire (SDQ). Outcomes included both continuous scores and categorical thresholds: borderline (≥6) and abnormal (≥7) hyperactivity–inattention symptoms. Multivariate linear and logistic regression models were conducted within each cohort to assess associations between elevated CRP levels (≥75th percentile) and ADHD symptoms. Results were then pooled using meta-analytic methods.Results: Borderline hyperactivity–inattention scores were observed in 21% of children in the ELFE cohort and 14% in EDEN. After adjusting for maternal sociodemographic, lifestyle, and pregnancy-related factors, as well as child characteristics at birth, elevated cord blood CRP was significantly associated with higher odds of ADHD symptoms: borderline scores (adjusted odds ratio [aOR] = 1.42; 95% CI: 1.08–1.86), abnormal scores (aOR = 1.48; 95% CI: 1.06–2.08), and increased continuous symptom scores (β = 0.29; 95% CI: 0.04–0.54). Conclusions: Higher CRP concentrations in cord blood are associated with greater ADHD symptom severity at age 5. These findings support the hypothesis that early-life inflammation may contribute to the developmental origins of ADHD and suggest that CRP could serve as a potential early biomarker of neurodevelopmental vulnerability.

Purpose Prenatal stress affects up to 74% of expectant mothers and has been implicated in shaping early child development. This study aims to examine the associations between both subjective (self-reported) and objective prenatal stress and infant temperament at 12 months of age. Additionally, we investigate whether maternal postpartum depression (PPD) mediates these associations. Methods We analyzed data from 1,510 mother-infant dyads in the French EDEN birth cohort. Prenatal stress was assessed using the State Anxiety Inventory (STAI), the Center for Epidemiological Studies Depression Scale (CES-D), and a measure of negative life events (NLEs). Infant temperament at 12 months was measured using the Emotionality Activity Sociability (EAS) questionnaire. Adjusted logistic regression models and mediation analyses were used to assess direct and indirect effects. Results Prenatal anxiety was associated with greater infant sociability, while prenatal depression predicted increased emotionality and shyness. Objective stress was related to lower infant activity. Mediation analyses revealed that PPD partially mediated the effects of prenatal depression and anxiety on infant emotionality and shyness, accounting for approximately 32% of the association between prenatal depression and infant emotional temperament. No mediation effect was found for the activity domain, although a small inverse direct association was observed. Conclusion Our findings suggest that maternal prenatal stress influences infant temperament in a trait-specific manner and that PPD plays a mediating role in certain domains. These results highlight the importance of addressing both prenatal and postnatal maternal stress when considering early emotional and behavioral development in children. Clinical trial number: not applicable.

Introduction: Adverse childhood experiences (ACEs) can impact individuals’ health later in life. In France, research on the prevalence and patterns of ACEs remains limited. This study aims to estimate the prevalence of different categories and profiles of ACEs in the French general population, and to explore their associations with childhood socioeconomic and demographic factors. Methods: A cross-sectional observational study was conducted using retrospective data from the CONSTANCES cohort, a large population-based cohort study in France, including adults aged 18 to 69 years at enrolment. The analytic sample included 101 071 participants with complete data on ACEs. Prevalence and typology of ACEs was assessed using the Behavioural Risk Factor Surveillance System questionnaire and examined individually, cumulatively and through latent class analysis (LCA) to identify exposure profiles. Associations with socioeconomic and demographic factors were examined using multinomial logistic regression, and all analyses were stratified by sex. Results: Overall, 65% of participants reported experiencing at least one ACE. Females were more likely than males to report certain experiences, including sexual violence. LCA identified three distinct ACE profiles in males (low exposure; physical and emotional violence; unstable family environment), and four in females (similar to males, with an additional class characterised by sexual violence). Class membership was associated with factors such as age, parental socioprofessional category and geographical origin. Conclusions: ACEs are highly prevalent in the French population and differ by sex. These findings emphasise the importance of social determinants, including gender and socioeconomic position, as risk factors.

Background: Despite the societal impact of the COVID‐19 pandemic, research assessing changes in symptoms of anxiety and depression following the sanitary crisis has reported heterogeneous evidence, especially among individuals with pre‐existing mental health conditions. Most earlier studies used summary scores of depression or anxiety assessment surveys, which does not provide insights into changes in individual symptoms and symptom structure during the pandemic. Objective: This study used a network analysis to investigate the symptom structure of anxiety and depressive symptoms and temporal changes in symptoms across three timepoints before and during the COVID‐19 pandemic in a sample primarily of persons with anxiety and depressive disorders. Methods: Data are retrieved from 675 participants of the Netherlands Study of Depression and Anxiety (NESDA) and Netherlands Study of Depression in Older Persons (NESDO) cohorts who completed all three timepoints. Anxiety and depressive symptoms were assessed using the Beck anxiety inventory (BAI) and the Quick Inventory of Depressive Symptomatology–Self‐Rated (QIDS–SR). Symptom networks were estimated for three timepoints: pre‐COVID, first COVID‐peak (April 2020), second COVID‐peak (January/February 2021), and compared. Symptom importance was quantified using centrality indices (strength, betweenness, and closeness), and temporal stability was assessed using the network comparison test (NCT). Results: The symptom networks were largely consistent between the two COVID‐19 peak timepoints but differed significantly from the pre‐COVID network in terms of global strength. Fear‐related anxiety symptoms, sleep‐related symptoms, and thoughts of death or suicide demonstrated greater strength centrality at the pre‐COVID timepoint compared to both COVID‐19 peak timepoints. Conclusion: Our findings illustrate that a stressful situation, such as the COVID‐19 pandemic, can result in changes in the complex associations of anxiety and depressive symptoms. Unexpectedly, anxiety symptom networks shifted from being driven by somatic fear responses before the pandemic, toward greater prominence of cognitive appraisal symptoms during the pandemic. Network insights could help focus intervention planning by targeting the key symptoms of anxiety and depression.

Purpose Postpartum depression symptoms (PPDS) and postpartum anxiety symptoms (PPAS) are a major global public health issue, especially in low-resource settings. This study aimed to determine the prevalence of PPDS and PPAS in Benin, Sub-Saharan Africa, at one year postpartum and to identify associated risk and protective factors. Methods Pregnant women were recruited for a longitudinal mother-child cohort in the Allada District of Benin, and a cross-sectional analysis was performed on data collected at one-year postpartum. Maternal depression and anxiety symptoms were assessed one year postpartum using the Edinburgh Postnatal Depression Scale (EPDS)—validated in Benin and translated into Fon—and its anxiety subscale (EPDS-3 A). Cut-off scores for high depressive and anxiety symptoms were ≥ 13 and ≥ 6, respectively. Potential risk and protective factors including maternal, child characteristics, socioeconomic status, and social support were analyzed using multivariable-adjusted logistic regression models. Results At one year postpartum, 13% of 742 mothers had PPDS, and 21% PPAS. Risk factors for PPDS included recent alcohol consumption (previous three months) (aOR = 1.88; 95%CI: 1.17–3.02) and food insecurity (aOR = 4.47; 95%CI: 1.29–17.4), while partner cohabitation reduced PPDS odds (aOR = 0.45; 95%CI: 0.26–0.80). PPAS risk factors included recent alcohol consumption (aOR = 2.17; 95%CI: 1.44–3.28) and regular child care support from 3 + childcare providers (aOR = 2.91; 95%CI: 1.50–5.68). Protective factors for PPAS included the minority Aizo ethnicity (aOR = 0.58; 95%CI: 0.36–0.93) and living in an individual house (aOR = 0.45; 95%CI: 0.24–0.85). Conclusion This study sheds light on the prevalence of PPDS and PPAS at one year postpartum in the Beninese context, as well as associated factors. Findings underscore the importance of establishing postpartum psychological follow-up and targeted strategies to support maternal mental health in low-resource settings, addressing both socioeconomic vulnerabilities and social support structures.

Background: The COVID-19 pandemic is often portrayed as a universal mental health crisis, especially in studies lacking pre-pandemic data. Research including pre-pandemic measures nonetheless yields mixed results, making the pandemic’s impact on mental health unclear, particularly when considering differences between general and clinical populations.Aims: This study examined depression and anxiety trajectories from pre-pandemic to peri-pandemic phases in general and clinical populations. It also explored how symptom trajectories varied by sociodemographic and pandemic-related factors.Method: Data from six cohorts in Germany, France, and the Netherlands were pooled within the Co-RESPOND project, comprising 2,796 participants. Cohorts were included based on available pre-pandemic data and at least two peri-pandemic assessments. Anxiety and depression symptoms were assessed using standardized measures and converted to z-scores for cross-cohort comparability. Symptom trajectories were identified using Latent Growth Mixture Modelling, and logistic regressions examined predictors of trajectory membership.Results: Participants had a median age of 42.3 years, with 65.6% being women. In the general population, approximately 80% showed decreasing symptoms, even among those with higher initial severity, while 20% maintained consistently low levels. In the clinical population, approximately half showed improvements from moderate symptom levels, with the remainder exhibiting consistently high or low symptoms. In the general population, divorce/separation and having children predicted more favourable anxiety and depression trajectories, while older age and childcare burden predicted less favourable trajectories. In the clinical population, being in a relationship, older age, and being a man were linked to more favourable anxiety trajectories.Conclusions: This study provides substantial evidence to refute the notion of the COVID-19 pandemic as a universal mental health crisis, showing that most adults across both general and clinical populations experienced stable or improving symptoms. Our findings underscore the need for mental health surveillance and responses that are proportionate and targeted, focusing on groups most at risk.