Maternal Postpartum Depression Increases Vulnerability for Toddler Behavior Problems through Infant Cortisol Reactivity

The current study examined the role of hypothalamic‐pituitary‐adrenal reactivity (a physiological indicator of stress) in early infancy as a mediator of the relationship between maternal postpartum depression and toddler behavior problems. Participants were 137 at‐risk mothers and their children participating in a longitudinal study of intergenerational transmission of risk. Mothers’ depression was measured five times during the infants’ first 18 months. Infant cortisol was collected during a social stressor (the still‐face paradigm) when infants were 6 months old, and mothers reported on toddlers’ internalizing and externalizing symptoms at 18 months. Among this sample of high‐risk mother–infant dyads, early postpartum depression predicted atypical infant cortisol reactivity at 6 months, which mediated the effect of maternal depression on increased toddler behavior problems. Clinical implications are discussed.