# Associations between attentional disengagement from distressed infant faces and cortisol reactivity are moderated by depressive symptoms in pregnant women: an eye-tracking study

## TL;DR

Pregnant women with depression show stronger stress responses when they have trouble disengaging from sad baby faces, suggesting a potential target for intervention.

## Contribution

The study reveals that depressive symptoms moderate the relationship between attention to infant distress and cortisol reactivity in pregnant women.

## Key findings

- Pregnant women showed stronger cortisol reactivity to stress compared to nulliparous women.
- Depressive symptoms moderated the link between disengagement from infant distress and cortisol reactivity in pregnant women.
- Maternal distress during infant distress processing could be an intervention target for depression.

## Abstract

Antenatal depression is a common psychological condition in pregnancy that negatively influences parenting. Theoretical models suggest that infant cue processing may represent one pathway by which depression may influence parenting. However, current understanding of how infant cue processing is linked with parenting in depression remains limited. Drawing upon previous research, cortisol stress reactivity may play an important role in this regard. The aim of the present study was to investigate the interaction between depressive symptoms and attentional disengagement from infant cues on cortisol reactivity. We examined this in a sample of pregnant and nulliparous women to test whether potential effects were specific to pregnancy.

N = 79 women (n = 36 pregnant) completed two eye-tracking tasks examining disengagement from adult and infant stimuli, a stress manipulation task including collection of salivary cortisol, and filled out the BDI-II.

Pregnant (vs. nulliparous) women showed a stronger cortisol reactivity in response to a stress test. Additionally, a significant association between disengagement from distressed infant faces and cortisol reactivity was found in the pregnant (but not nulliparous) group, which was moderated by depressive symptoms. For pregnant women with low levels of depressive symptoms, a slower disengagement from distressed infant stimuli predicted a weaker cortisol reactivity in response to stress, while the opposite pattern was observed for pregnant women with high levels of depressive symptoms.

Findings of the present study point at maternal distress during processing of infant distress as a potential intervention target for mothers with depression.

The online version contains supplementary material available at 10.1007/s00737-025-01638-2.

• Pregnant (vs. nulliparous) women showed a stronger cortisol stress reactivity.

• Depression moderated the link between disengagement from infant distress and cortisol reactivity in pregnant women.

• For pregnant women high on depression, slower disengagement predicted stronger cortisol reactivity.

• For pregnant women low on depression, slower disengagement predicted weaker cortisol reactivity.

• Maternal distress in response to infant distress could offer an intervention target for mothers with depression.

The online version contains supplementary material available at 10.1007/s00737-025-01638-2.