Positive and negative maternal mental health demonstrate distinct pathways to childhood depression.

BACKGROUND: Maternal mental health strongly influences child development and depression risk. This study investigated how positive and negative dimensions of prenatal maternal mental health differentially shape childhood depressive symptoms through cognitive mediators. METHODS: Participants were drawn from the (GUSTO) cohort. Of the 1198 mother-child dyads enrolled, 523 (52.6% boys) had sufficient data for the mediation analysis. Maternal mental health at 26 weeks' gestation was assessed using a bifactor model derived from the Beck Depression Inventory-II, State-Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale. Child language ability was measured at age 2 years with the Bayley Scales of Infant Development, executive function at age 7 years with the Behaviour Rating Inventory of Executive Function, and depressive symptoms at age 9 years with the Children's Depression Inventory-2. Serial mediation models tested hypothesized pathways. RESULTS: Distinct mediation pathways emerged. Positive maternal mental health was associated with enhanced early language ability, which in turn was associated with fewer depressive symptoms in later childhood ( = -0.017, 95% CI: -0.042, -0.003). Conversely, negative maternal mental health was associated with poorer executive functioning, which in turn was associated with more depressive symptoms ( = 0.040, 95% CI: 0.016-0.077). CONCLUSIONS: Positive and negative maternal mental health are linked to childhood depressive symptoms through distinct neurocognitive pathways. By identifying language and executive function as specific developmental mediators, our findings point to targeted and developmentally sensitive intervention opportunities to disrupt intergenerational pathways of depression.