Maternal behavioral health symptom profiles in early family life: complexity and context

  • Nomi S. Weiss-LaxerEmail author
  • Sara B. Johnson
  • Sharon R. Ghazarian
  • Lauren M. Osborne
  • Anne W. Riley
Original Article


Behavioral health problems affect at least 15% of mothers, but few studies have examined how different problems cluster together. Characterizing symptom profiles and their correlates early in the family life cycle can extend existing understanding beyond that provided by studies based on single problems. Mothers in the Fragile Families and Child Wellbeing study, a national birth cohort of racially diverse and mostly unmarried mothers (N = 4205), reported depression, anxiety, and substance dependence symptoms. Latent class analysis (LCA) identified mothers’ symptom profiles in their children’s third year. We explored associations between symptom profiles and demographics, reproductive health outcomes, functional limitations, and postpartum behavioral health. LCA identified five profiles: (1) Depression only (14.5% of sample), (2) Severe depression and anxiety (5.3%), (3) Anxiety only (2.2%), (4) Depression and substance use (1.4%), and (5) Currently symptom free (76.6%). Depressive symptoms were more moderate when co-occurring with substance dependence and more severe when co-occurring with anxiety. Postpartum depression, postpartum anxiety, and smoking during pregnancy were the most robust correlates of being symptomatic in year 3. Mothers in the “Severe depression and anxiety” group were more likely to be in that profile if they reported functional impairment and/or relationship dissolution. Mothers in the “Depression only” profile were more likely to have higher parity and/or functional impairment. A quarter of mothers of young children had significant behavioral health symptoms, with most reporting depression symptoms. Psychosocial and physical health factors in the pregnancy and postpartum periods were associated with future symptoms, warranting obstetrician and pediatrician attention.


Maternal behavioral health Latent class analysis Fragile families Early childhood 



Dr. Weiss-Laxer was supported by the C. Sylvia and Eddie C. Brown Community Health Scholarship. Dr. Osborne’s research was supported by the NIH 1K23 MH110607-01A1 and Doris Duke Early Clinician Investigator Award.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

737_2019_987_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 19 kb)


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Nomi S. Weiss-Laxer
    • 1
    Email author
  • Sara B. Johnson
    • 1
    • 2
  • Sharon R. Ghazarian
    • 3
  • Lauren M. Osborne
    • 4
  • Anne W. Riley
    • 1
  1. 1.Department of Population Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Department of PediatricsJohns Hopkins School of MedicineBaltimoreUSA
  3. 3.Health InformaticsJohns Hopkins All Children’s HospitalSt. PetersburgUSA
  4. 4.Departments of Psychiatry & Behavioral Sciences and Gynecology & ObstetricsJohns Hopkins School of MedicineBaltimoreUSA

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