Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Population
2.3. Assessment of In Utero Exposure to Maternal Mental Health
2.4. Assessment of Children’s Cognitive Development
2.5. Covariates
2.6. Statistical Analysis
2.7. Sensitivity Analyses
2.8. Ethics
3. Results
3.1. Description of Children and Their Mothers
3.2. Maternal Mental Health
3.3. Children’s Cognitive Development Scores Using ASQ-3 Domains
3.4. Association between Maternal Mental Health and Child Cognitive Development Using the Ages & Stages Questionnaire ASQ-3
3.5. Sensitivity Analyses
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall | Depression Status during Pregnancy h | Anxiety Status during Pregnancy i | |||||
---|---|---|---|---|---|---|---|
N = 472 (%) | None to Mild, N = 273 (57.8%) | Moderate to Severe, N = 199 (42.2%) | p-Value | None to Mild, N = 425 (90%) | Moderate to Severe, N = 47 (10%) | p-Value | |
Newborn sex | 0.049 | 0.79 | |||||
Female | 202 (48.3) | 107 (44.2) | 95 (54.0) | 183 (48.5) | 19 (46.3) | ||
Male | 216 (51.7) | 135 (55.8) | 81 (46.0) | 194 (51.5) | 22 (53.7) | ||
Missing | 54 | 31 | 23 | 48 | 6 | ||
Gestational age at birth, weeks, Mean (SD) | 39.1 (1.7) | 39.3 (1.6) | 38.9 (1.8) | 0.042 | 39.2 (1.7) | 38.7 (1.5) | 0.064 |
a Prematurity | 19 (4.4) | 8 (3.2) | 11 (6.1) | 0.16 | 17 (4.4) | 2 (4.7) | >0.99 |
Missing | 45 | 26 | 19 | 41 | 4 | ||
Malformation | 32 (7.5) | 13 (5.3) | 19 (10.6) | 0.041 | 26 (6.8) | 6 (14.0) | 0.12 |
Missing | 46 | 27 | 19 | 42 | 4 | ||
Weight at birth, kilogram, mean (SD) | 3.3 (0.5) | 3.3 (0.5) | 3.3 (0.6) | 0.48 | 3.3 (0.5) | 3.2 (0.4) | 0.15 |
Missing | 56 | 31 | 25 | 49 | 7 | ||
b Low birth weigth | 25 (6.0) | 12 (4.9) | 13 (7.4) | 0.29 | 22 (5.8) | 3 (7.3) | 0.72 |
Missing | 52 | 29 | 23 | 46 | 6 | ||
Breastfeeding | 332 (78.5) | 196 (80.7) | 136 (75.6) | 0.21 | 302 (79.5) | 30 (69.8) | 0.14 |
Missing | 49 | 30 | 19 | 45 | 4 | ||
Jaundice | 83 (22.0) | 38 (17.6) | 45 (27.8) | 0.018 | 73 (21.5) | 10 (26.3) | 0.49 |
Missing | 94 | 57 | 37 | 85 | 9 | ||
Delivery mode | 0.27 | 0.072 | |||||
Caesarean, planned | 53 (13.3) | 26 (11.4) | 27 (15.9) | 45 (12.6) | 8 (19.5) | ||
Caesarean, urgent | 51 (12.8) | 33 (14.4) | 18 (10.6) | 50 (14.0) | 1 (2.4) | ||
Vaginal | 295 (73.9) | 170 (74.2) | 125 (73.5) | 263 (73.5) | 32 (78.0) | ||
Missing | 73 | 44 | 29 | 67 | 32 (78.0) | ||
Child COVID-19 infection | 264 (56.2) | 158 (57.9) | 106 (53.8) | 0.38 | 243 (57.4) | 21 (44.7) | 0.094 |
Missing | 2 | 0 | 2 | 2 | 0 | ||
Third edition of Ages & Stages questionnaire domains | |||||||
Communication score, mean (SD) | 39.3 (13.6) | 39.1 (13.1) | 39.5 (14.2) | 0.78 | 40 (13.2) | 32.8 (15.2) | 0.003 |
Missing | 1 | 0 | 1 | 0 | 1 | ||
c Communication categories | 0.70 | 0.009 | |||||
DS | 379 (80.5) | 220 (80.6) | 159 (80.3) | 348 (81.9) | 31 (67.4) | ||
RLAM | 11 (2.3) | 5 (1.8) | 6 (3.0) | 7 (1.6) | 4 (8.7) | ||
FARP | 81 (17.2) | 48 (17.6) | 33 (16.7) | 70 (16.5) | 11 (23.9) | ||
Missing | 1 | 0 | 1 | 0 | 1 | ||
Gross motor score, mean (SD) | 53.5 (11.0) | 53.4 (10.8) | 53.6 (11.3) | 0.88 | 53.8 (10.7) | 50.7 (13.0) | 0.13 |
Missing | 2 | 2 | 0 | 2 | 0 | ||
d Gross motor categories | 0.85 | 0.013 | |||||
DS | 385 (81.9) | 223 (82.3) | 162 (81.4) | 353 (83.5) | 32 (68.1) | ||
RLAM | 41 (8.7) | 22 (8.1) | 19 (9.5) | 36 (8.5) | 5 (10.6) | ||
FARP | 44 (9.4) | 26 (9.6) | 18 (9.0) | 34 (8.0) | 10 (21.3) | ||
Missing | 2 | 2 | 0 | 2 | 0 | ||
Fine motor score, mean (SD) | 53.2 (8.4) | 52.8 (8.7) | 53.7 (8.0) | 0.28 | 53.4 (8.0) | 51.3 (11.5) | 0.22 |
Missing | 2 | 2 | 0 | 2 | 0 | ||
e Fine motor categories | 0.81 | 0.19 | |||||
DS | 419 (89.1) | 241 (88.9) | 178 (89.4) | 379 (89.6) | 40 (85.1) | ||
RLAM | 12 (2.6) | 8 (3.0) | 4 (2.0) | 9 (2.1) | 3 (6.4) | ||
FARP | 39 (8.3) | 22 (8.1) | 17 (8.5) | 35 (8.3) | 4 (8.5) | ||
Missing | 2 | 2 | 0 | 2 | 0 | ||
Problem-solving score, mean (SD) | 45.3 (10.9) | 44.3 (11.1) | 46.8 (10.5) | 0.014 | 45.4 (10.9) | 44.5 (11.4) | 0.60 |
Missing | 14 | 6 | 8 | 12 | 2 | ||
f Problem solving categories | 0.024 | 0.71 | |||||
DS | 358 (78.2) | 197 (73.8) | 161 (84.3) | 322 (78.0) | 36 (80.0) | ||
RLAM | 33 (7.2) | 22 (8.2) | 11 (5.8) | 29 (7.0) | 4 (8.9) | ||
FARP | 67 (14.6) | 48 (18.0) | 19 (9.9) | 62 (15.0) | 5 (11.1) | ||
Missing | 14 | 6 | 8 | 12 | 2 | ||
Personal and social score, mean (SD) | 47.4 (9.1) | 46.8 (9.4) | 48.3 (8.5) | 0.076 | 47.6 (9.0) | 46 (9.5) | 0.28 |
Missing | 10 | 5 | 5 | 9 | 1 | ||
g Personal and social categories | 0.36 | 0.37 | |||||
DS | 406 (87.9) | 234 (87.3) | 172 (88.7) | 368 (88.5) | 38 (82.6) | ||
RLAM | 13 (2.8) | 10 (3.7) | 3 (1.5) | 11 (2.6) | 2 (4.3) | ||
FARP | 43 (9.3) | 24 (9.0) | 19 (9.8) | 37 (8.9) | 6 (13.0) | ||
Missing | 10 | 5 | 5 | 9 | 1 |
Overall | k Depression Status during Pregnancy | l Anxiety Status during Pregnancy | |||||
---|---|---|---|---|---|---|---|
N = 472 (%) | None to Mild, N = 273 (57.8%) | Moderate to Severe, N = 199 (42.2%) | p-Value | None to Mild, N = 425 (90%) | Moderate to Severe, N = 47 (10%) | p-Value | |
Maternal age at baseline, Mean (SD) | 32.6 (4.0) | 32.3 (3.7) | 33 (4.4) | 0.065 | 32.6 (3.9) | 32.2 (4.6) | 0.54 |
Period of recruitment | 0.73 | 0.091 | |||||
2020 | 390 (82.6) | 227 (83.2) | 163 (81.9) | 347 (81.6) | 43 (91.5) | ||
2021 | 82 (17.4) | 46 (16.8) | 36 (18.1) | 78 (18.4) | 4 (8.5) | ||
Annual household income, CAD | 0.85 | 0.80 | |||||
≤$90,000 | 102 (22.7) | 55 (21.3) | 47 (24.6) | 93 (23.0) | 9 (20.5) | ||
$90,001–120,000 | 124 (27.6) | 71 (27.5) | 53 (27.7) | 112 (27.7) | 12 (27.3) | ||
$120,001–150,000 | 87 (19.4) | 52 (20.2) | 35 (18.3) | 80 (19.8) | 7 (15.9) | ||
≥$150,000 | 136 (30.3) | 80 (31.0) | 56 (29.3) | 120 (29.6) | 16 (36.4) | ||
Missing | 23 | 15 | 8 | 20 | 3 | ||
Marital status—Living alone | 0.15 | >0.99 | |||||
No | 455 (96.8) | 267 (97.8) | 188 (95.4) | 410 (96.7) | 45 (97.8) | ||
Yes | 15 (3.2) | 6 (2.2) | 9 (4.6) | 14 (3.3) | 1 (2.2) | ||
Missing | 2 | 0 | 2 | 1 | 1 | ||
Area of residence | 0.10 | 0.022 | |||||
Rural | 52 (11.1) | 23 (8.5) | 29 (14.6) | 51 (12.1) | 1 (2.1) | ||
Suburban | 194 (41.4) | 118 (43.5) | 76 (38.4) | 167 (39.6) | 27 (57.4) | ||
Urban | 223 (47.5) | 130 (48.0) | 93 (47.0) | 204 (48.3) | 19 (40.4) | ||
Missing | 3 | 2 | 1 | 3 | 0 | ||
a Education, years, mean (SD) | 17.3 (4.8) | 17.6 (4.3) | 17 (5.3) | 0.22 | 17.6 (4.4) | 15.2 (6.8) | 0.025 |
Missing | 2 | 0 | 2 | 2 | 0 | ||
Pre-pregnancy body mass index, Mean (SD) | 25.2 (5.3) | 24.8 (4.9) | 25.7 (5.7) | 0.086 | 25 (5.3) | 26.5 (5.3) | 0.077 |
Missing | 4 | 2 | 2 | 3 | 1 | ||
Ethnicity/race | |||||||
Caucasian/white | 439 (93.2) | 256 (94.1) | 183 (92.0) | 0.36 | 397 (93.6) | 42 (89.4) | 0.35 |
Other | 32 (6.8) | 16 (5.9) | 16 (8.0) | 27 (6.4) | 5 (10.6) | ||
Missing | 1 | 1 | 0 | 1 | 0 | ||
Alcohol consumption | 10 (2.1) | 6 (2.2) | 4 (2.0) | >0.99 | 9 (2.1) | 1 (2.1) | >0.99 |
Missing | 3 | 2 | 1 | 3 | 0 | ||
Smoking | 4 (0.8) | 3 (1.1) | 1 (0.5) | 0.64 | 3 (0.7) | 1 (2.1) | 0.34 |
Missing | 1 | 1 | 0 | 1 | 0 | ||
Use of cannabis products | 3 (0.6) | 1 (0.4) | 2 (1.0) | 0.58 | 3 (0.7) | 0 (0.0) | >0.99 |
Missing | 1 | 1 | 0 | 1 | 0 | ||
Diabetes | 55 (11.8) | 31 (11.5) | 24 (12.2) | 0.82 | 45 (10.7) | 10 (21.7) | 0.027 |
Missing | 5 | 3 | 2 | 4 | 1 | ||
Hypertension | 50 (10.7) | 20 (7.4) | 30 (15.2) | 0.007 | 43 (10.2) | 7 (15.2) | 0.31 |
Missing | 5 | 3 | 2 | 4 | 1 | ||
Asthma | 43 (9.8) | 23 (9.2) | 20 (10.8) | 0.58 | 35 (8.8) | 8 (19.5) | 0.047 |
Missing | 35 | 22 | 13 | 29 | 6 | ||
Tylenol use | 204 (44.3) | 110 (41.4) | 94 (48.5) | 0.13 | 180 (43.4) | 24 (53.3) | 0.20 |
Missing | 12 | 7 | 5 | 10 | 2 | ||
Over-the-counter medication | 129 (28.0) | 67 (25.2) | 62 (32.0) | 0.11 | 113 (27.2) | 16 (35.6) | 0.24 |
Missing | 12 | 7 | 5 | 10 | 2 | ||
b Medication use during pregnancy | 321 (68.9) | 172 (63.7) | 149 (76.0) | 0.005 | 284 (67.5) | 37 (82.2) | 0.042 |
Missing | 6 | 3 | 3 | 4 | 2 | ||
c CASC150 score, mean (SD) | 27.5 (9.9) | 25.2 (8.5) | 30.8 (10.7) | <0.001 | 26.9 (9.4) | 33 (12.1) | 0.002 |
Missing | 21 | 13 | 8 | 20 | 1 | ||
d Threat score, mean (SD) | 3.4 (3.9) | 2.9 (3.5) | 4.1 (4.3) | 0.002 | 3.2 (3.7) | 4.8 (5.1) | 0.039 |
Missing | 2 | 1 | 1 | 2 | 0 | ||
e Loss score, mean (SD) | 4.3 (6.9) | 3.5 (5.8) | 5.5 (8.0) | 0.003 | 4 (6.7) | 7 (7.9) | 0.017 |
Missing | 3 | 2 | 1 | 3 | 0 | ||
f Change score, mean (SD) | 19.7 (4.5) | 18.6 (4.1) | 21.3 (4.6) | <0.001 | 19.5 (4.3) | 21.7 (5.5) | 0.011 |
Missing | 16 | 10 | 6 | 15 | 1 | ||
History of depression | 67 (14.2) | 33 (12.1) | 34 (17.1) | 0.12 | 61 (14.4) | 6 (12.8) | 0.77 |
History of anxiety | 76 (16.2) | 30 (11.0) | 46 (23.2) | <0.001 | 60 (14.2) | 16 (34.0) | <0.001 |
Missing | 2 | 1 | 1 | 2 | 0 | ||
gAntidepressant use | 98 (20.8) | 42 (15.4) | 56 (28.1) | <0.001 | 79 (18.6) | 19 (40.4) | <0.001 |
Gestational age at recruitment, weeks, mean (SD) | 20 (8.2) | 19.4 (8.2) | 20.9 (8.0) | 0.038 | 20.1 (8.2) | 19.3 (8.2) | 0.52 |
h Maternal depression h, mean (SD) | 7.9 (5.4) | 4.1 (2.7) | 13 (3.5) | <0.001 | 7 (4.8) | 15.4 (4.8) | <0.001 |
i Maternal anxiety i , mean (SD) | 4.3 (3.9) | 2.4 (2.4) | 7 (4.0) | <0.001 | 3.3 (2.5) | 13.3 (2.8) | <0.001 |
j Maternal stress j, mean (SD) | 4.5 (2.1) | 3.6 (1.9) | 5.7 (1.8) | <0.001 | 4.3 (2.0) | 6.6 (1.9) | <0.001 |
e Development on Schedule | f Activities, Monitoring Required | Crude OR (95%CI) | * Adjusted OR (95%CI) | g Further Assessement Required | Crude OR (95%CI) | * Adjusted OR (95% CI) | |
---|---|---|---|---|---|---|---|
Communication | |||||||
a In utero exposure to maternal depression | |||||||
None to mild (EPDS < 9) | 220 (58.0) | 48 (59.3) | Reference | Reference | 5 (45.5) | Reference | Reference |
Moderate to severe (EPDS ≥ 9) | 159 (42.0) | 33 (40.7) | 0.95 (0.58; 1.55) | 0.82 (0.43; 1.54) | 6 (54.5) | 1.66 (0.50; 5.54) | 0.73 (0.13; 4.14) |
b In utero exposure to maternal anxiety | |||||||
None to mild (GAD-7 ≤ 9) | 348 (91.8) | 70 (86.4) | Reference | Reference | 7 (63.6) | Reference | Reference |
Moderate to severe (GAD-7 > 9) | 31 (8.2) | 11 (13.6) | 1.76 (0.85; 3.68) | 2.32 (0.92; 5.86) | 4 (36.4) | 6.41 (1.78; 23.1) | 12.2 (1.60; 92.4) |
c In utero exposure to stress related to the COVID-19 pandemic, mean (SD) | 4.5 (2.1) | 4.5 (2.1) | 1.00 (0.89; 1.12) | 1.00 (0.87; 1.16) | 5.1 (2.5) | 1.15 (0.86; 1.54) | 1.21 (0.80; 1.84) |
d In utero exposure to maternal antidepressants | |||||||
No | 307 (81.0) | 58 (71.6) | Reference | Reference | 9 (81.8) | Reference | Reference |
Yes | 72 (19.0) | 23 (28.4) | 1.69 (0.98; 2.92) | 1.28 (0.48; 3.42) | 2 (18.2) | 0.95 (0.20; 4.48) | 0.33 (0.02; 6.06) |
Gross motor | |||||||
In utero exposure to maternal depression | |||||||
None to mild (EPDS < 9) | 223.0 (57.9) | 26.0 (59.1) | Reference | Reference | 22.0 (53.7) | Reference | Reference |
Moderate to severe (EPDS ≥ 9) | 162.0 (42.1) | 18.0 (40.9) | 0.95 (0.51; 1.80) | 0.64 (0.26; 1.55) | 19.0 (46.3) | 1.19 (0.62; 2.27) | 0.89 (0.40; 2.00) |
In utero exposure to maternal anxiety | |||||||
None to mild (GAD-7 ≤ 9) | 353.0 (91.7) | 34.0 (77.3) | Reference | Reference | 36.0 (87.8) | Reference | Reference |
Moderate to severe (GAD-7 > 9) | 32.0 (8.3) | 10.0 (22.7) | 3.24 (1.47; 7.17) | 6.33 (2.06; 19.4) | 5.0 (12.2) | 1.53 (0.56; 4.18) | 1.33 (0.39; 4.57) |
In utero exposure to stress related to the COVID-19 pandemic, mean (SD) | 4.5 (2.1) | 4.4 (1.8) | 0.99 (0.85; 1.15) | 0.96 (0.79; 1.17) | 4.9 (2.1) | 1.09 (0.94; 1.28) | 1.16 (0.95; 1.41) |
In utero exposure to maternal antidepressants | |||||||
No | 310.0 (80.5) | 32.0 (72.7) | Reference | Reference | 32.0 (78.0) | Reference | Reference |
Yes | 75.0 (19.5) | 12.0 (27.3) | 1.55 (0.76; 3.15) | 2.27 (0.59; 8.82) | 9.0 (22.0) | 1.16 (0.53; 2.54) | 1.59 (0.42; 5.97) |
Fine motor | |||||||
In utero exposure to maternal depression | |||||||
None to mild (EPDS < 9) | 241.0 (57.5) | 22.0 (56.4) | Reference | Reference | 8.0 (66.7) | Reference | Reference |
Moderate to severe (EPDS ≥ 9) | 178.0 (42.5) | 17.0 (43.6) | 1.05 (0.54; 2.03) | 1.55 (0.65; 3.69) | 4.0 (33.3) | 0.68 (0.20; 2.28) | 0.25 (0.04; 1.70) |
In utero exposure to maternal anxiety | |||||||
None to mild (GAD-7 ≤ 9) | 379.0 (90.5) | 35.0 (89.7) | Reference | Reference | 9.0 (75.0) | Reference | Reference |
Moderate to severe (GAD-7 > 9) | 40.0 (9.5) | 4.0 (10.3) | 1.08 (0.37; 3.20) | 1.18 (0.31; 4.50) | 3.0 (25.0) | 3.16 (0.82; 12.1) | 7.73 (0.85; 70.0) |
In utero exposure to stress related to the COVID-19 pandemic, mean (SD) | 4.5 (2.1) | 4.0 (2.2) | 0.88 (0.75; 1.03) | 0.85 (0.68; 1.05) | 4.8 (2.3) | 1.05 (0.80; 1.38) | 1.07 (0.74; 1.53) |
In utero exposure to maternal antidepressants | |||||||
No | 334.0 (79.7) | 30.0 (76.9) | Reference | Reference | 10.0 (83.3) | Reference | Reference |
Yes | 85.0 (20.3) | 9.0 (23.1) | 1.18 (0.54; 2.58) | 4.11 (1.00; 16.9) | 2.0 (16.7) | 0.79 (0.17; 3.65) | 0.42 (0.02; 8.58) |
Problem solving | |||||||
In utero exposure to maternal depression | |||||||
None to mild (EPDS < 9) | 197 (55.0) | 48 (71.6) | Reference | 22 (66.7) | Reference | ||
Moderate to severe (EPDS ≥ 9) | 161 (45.0) | 19 (28.4) | 0.48 (0.27; 0.86) | 0.48 (0.24; 0.98) | 11 (33.3) | 0.61 (0.29; 1.30) | 0.48 (0.18; 1.26) |
In utero exposure to maternal anxiety | |||||||
None to mild (GAD-7 ≤ 9) | 322 (89.9) | 62 (92.5) | Reference | Reference | 29 (87.9) | Reference | Reference |
Moderate to severe (GAD-7 > 9) | 36 (10.1) | 5 (7.5) | 0.72 (0.27; 1.91) | 0.95 (0.30; 3.01) | 4 (12.1) | 1.23 (0.41; 3.71) | 1.34 (0.34; 5.32) |
In utero exposure to stress related to the COVID-19 pandemic, mean (SD) | 4.5 (2.1) | 4.1 (1.9) | 0.91 (0.80; 1.04) | 1.03 (0.88; 1.20) | 4.5 (2.3) | 0.98 (0.83; 1.16) | 1.05 (0.85; 1.29) |
In utero exposure to maternal antidepressants | |||||||
No | 281 (78.5) | 56 (83.6) | Reference | Reference | 27 (81.8) | Reference | Reference |
Yes | 77 (21.5) | 11 (16.4) | 0.72 (0.36; 1.43) | 0.85 (0.24; 2.97) | 6 (18.2) | 0.81 (0.32; 2.03) | 0.67 (0.12; 3.87) |
Personal–social | |||||||
In utero exposure to maternal depression in utero | |||||||
None to mild (EPDS < 9) | 234 (57.6) | 24 (55.8) | Reference | Reference | 10 (76.9) | Reference | Reference |
Moderate to severe (EPDS ≥ 9) | 172 (42.4) | 19 (44.2) | 1.08 (0.57; 2.03) | 1.39 (0.62; 3.12) | 3 (23.1) | 0.41 (0.11; 1.51) | 0.23 (0.04; 1.33) |
Anxiety in utero | |||||||
None to mild (GAD-7 ≤ 9) | 368 (90.6) | 37 (86) | Reference | Reference | 11 (84.6) | Reference | Reference |
Moderate to severe (GAD-7 > 9) | 38 (9.4) | 6 (14) | 1.57 (0.62; 3.96) | 2.03 (0.68; 6.04) | 2 (15.4) | 1.76 (0.38; 8.24) | 3.59 (0.45; 28.9) |
In utero exposure to stress related to the COVID-19 pandemic, mean (SD) | 4.5 (2.1) | 4 (2.2) | 0.89 (0.77; 1.04) | 0.84 (0.69; 1.02) | 4.7 (1.8) | 1.04 (0.80; 1.36) | 1.23 (0.86; 1.76) |
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Ait Belkacem, N.; Gorgui, J.; Tchuente, V.; Aubin, D.; Lippé, S.; Bérard, A. Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study). J. Clin. Med. 2024, 13, 1055. https://doi.org/10.3390/jcm13041055
Ait Belkacem N, Gorgui J, Tchuente V, Aubin D, Lippé S, Bérard A. Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study). Journal of Clinical Medicine. 2024; 13(4):1055. https://doi.org/10.3390/jcm13041055
Chicago/Turabian StyleAit Belkacem, Narimene, Jessica Gorgui, Vanina Tchuente, Delphine Aubin, Sarah Lippé, and Anick Bérard. 2024. "Maternal Mental Health in Pregnancy and Its Impact on Children’s Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study)" Journal of Clinical Medicine 13, no. 4: 1055. https://doi.org/10.3390/jcm13041055