# Postpartum depression and the moderating role of empathy on child physiological reactivity

## TL;DR

This study shows that postpartum depression affects children's stress responses, but maternal empathy can reduce this impact.

## Contribution

The study identifies empathy as a novel moderator of the link between maternal depression and child physiological reactivity.

## Key findings

- Postpartum depression predicted offspring heart rate variability (HRV) activity.
- Empathy significantly moderated the relationship between maternal depression and child HRV.
- Perinatal attachment did not show a moderating effect on this relationship.

## Abstract

Perinatal maternal depression is a risk factor for the development of psychopathology in the offspring, probably by impacting its early physiological reactivity to stress and emotion regulation. The objective of this study is to evaluate the influence of postpartum depressive symptoms on the offspring’s physiological reactivity (heart rate variability -HRV) and the possible moderating effects of empathy and perinatal attachment.

We recruited 24 mother-child dyads in a prospective observational study. The psychopathological profile and personal characteristics of pregnant women at 24–28 gestational weeks were evaluated by administrating the Perinatal Attachment Inventory (PAI) and the Empathy Quotient (EQ) questionnaire. Three weeks after childbirth, women completed the Edinburgh Postnatal Depression Scale (EPDS), and the offspring underwent an HRV recording.

Postpartum depression was a good predictor of the offspring’s HRV activity (b = 1.49, p =.045). Both perinatal attachment (r=-.463, p =.023, Fisher’s ES=-0.501) and empathy (r=-.570, p =.004, Fisher’s ES=-0.648) were negatively associated with postpartum depression. Finally, empathy showed a moderator effect on the association between postpartum depression and child’s HRV (b = 0.13, p =.03). We found no moderator effects for Perinatal Attachment.

Despite the preliminary nature of our data, maternal depression showed predictive power on offspring’s early regulatory mechanisms, with possible knock-on effects on emotional regulation and mother-child bond establishment. Interestingly, some maternal personality characteristics, such as empathy, can influence the development of depression symptoms, suggesting the presence of moderator factors modulating the association between maternal psychological status and child physiological reactivity.

The online version contains supplementary material available at 10.1186/s13052-025-02063-y.