Objective hardship during pregnancy and child social-emotional outcomes at 2 years of age in the Pregnancy During the Pandemic Cohort

Background The COVID-19 pandemic and associated stressors contributed to increased mental health concerns (e.g., anxiety and depression). Objective stress among expectant parents poses a risk for child development, with previous studies demonstrating that exposure to stress in-utero can have negative implications for social-emotional development. Objective To assess the association between pandemic-related objective hardship and psychological distress (i.e., anxiety and depression) during pregnancy and postpartum and child social-emotional development at 24 months. Study design Participants were from the longitudinal Pregnancy during the Pandemic (PdP) cohort. They were largely White, educated, and in married or common-law relationships. Pandemic-related objective hardship was assessed during pregnancy, psychological distress was assessed during pregnancy and postpartum, and child social-emotional development was assessed at 24 months of age. Serial Mediation Analysis was used to examine the strength of the association between objective hardship, psychological distress during pregnancy and postpartum, and child social-emotional outcomes. Results Participants who provided social-emotional development outcome data at 24 months were included in the analysis (n = 3889). Greater exposure to pandemic-related objective hardship was associated with worse social-emotional development at 24 months through the effects of prenatal and postpartum psychological distress ( B =1.33; SE =0.22; p < .001). Conclusions Exposure to more pandemic-related objective hardship was associated with a higher likelihood of child social-emotional developmental concerns. Greater psychological distress following hardship in the prenatal and postpartum periods partially explains this association.