A Meta-Analysis of Maternal Prenatal Depression and Anxiety on Child Socioemotional Development (original) (raw)
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Neuroscience & Biobehavioral Reviews
Maternal psychological distress, life event stress, and objective exposure affect offspring outcome. Functional and structural brain changes underlie the problems observed in the offspring. Alterations in stress system, immune system, and gut microbiome play a significant role. Epigenetic and telomere biology mechanisms are beginning to be explored. Interventions focused on offspring also need to be guided by knowledge of changes in biological systems.
Archives of women's mental health, 2016
Perinatal psychological stress has been associated with unfavorable maternal and neonatal outcomes. We aimed to assess the impact of perinatal stress on infant development at 1 year of age. We recruited pregnant women calling North American Teratogen Information Services or attending outpatient clinics at CHU Sainte Justine (Montreal) between 2008 and 2010 and their spouses. To be part of our study, women had to be (1) >18 years of age, (2) <15 weeks of gestational age at recruitment, (3) living within 250-km radius of Montreal, and (4) taking antidepressants or non-teratogenic drugs. Stress was assessed using the telephone-administered four-item perceived stress scale during pregnancy in mothers and at 2 months postpartum in both parents. Child development at 1 year of age was evaluated with the Bayley III scales. Sociodemographic and potential confounders were collected through telephone interviews. Multivariable linear regression models were built to assess the association between perinatal parental stress and child development. Overall, 71 couples and their infants were included. When adjusted for potential confounders, maternal prenatal stress was positively associated with motor development (adjusted β = 1.85, CI 95 % (0.01, 3.70)). Postpartum maternal and paternal stresses were negatively associated with motor and socio-emotional development, respectively (adjusted β = −1.54, CI 95 % (−3.07, −0.01) and adjusted β = −1.67, CI 95 % (−3.25, −0.10), respectively). Maternal and paternal postnatal stress seems to be harmful for the motor and socio-emotional development in 1-year-old children. No association was demonstrated between parental stress and cognitive, language, and adaptive behavioral development. However, prenatal maternal stress appears to improve motor skills.
JAMA Pediatrics, 2020
IMPORTANCE There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic, meta-analytic review on the long-term developmental outcomes spanning infancy through adolescence. OBJECTIVE To provide a comprehensive systematic review and meta-analysis of the extant literature on associations between maternal perinatal depression and anxiety and social-emotional, cognitive, language, motor, and adaptability outcomes in offspring during the first 18 years of life. DATA SOURCES Six databases were searched (CINAHL Complete, Cochrane Library, Embase, Informit, MEDLINE Complete, and PsycInfo) for all extant studies reporting associations between perinatal maternal mental health problems and offspring development to March 1, 2020. STUDY SELECTION Studies were included if they were published in English; had a human sample, quantitative data, a longitudinal design, and measures of perinatal depression and/or anxiety and social-emotional, cognitive, language, motor, and/or adaptability development in offspring; and investigated an association between perinatal depression or anxiety and childhood development. DATA EXTRACTION AND SYNTHESIS Of 27 212 articles identified, 191 were eligible for meta-analysis. Data were extracted by multiple independent observers and pooled using a fixed-or a random-effects model. A series of meta-regressions were also conducted. MAIN OUTCOMES AND MEASURES Primary outcomes included social-emotional, cognitive, language, motor, and adaptability development in offspring during the first 18 years of life. RESULTS After screening, 191 unique studies were eligible for meta-analysis, with a combined sample of 195 751 unique mother-child dyads. Maternal perinatal depression and anxiety were associated with poorer offspring social-emotional (antenatal period, r = 0.21 [95% CI, 0.16-0.27]; postnatal period, r = 0.24 [95% CI, 0.19-0.28]), cognitive (antenatal period, r = −0.12 [95% CI,-0.19 to-0.05]; postnatal period, r = −0.25 [95% CI,-0.39 to-0.09]), language (antenatal period, r = −0.11 [95% CI, −0.20 to 0.02]; postnatal period, r = −0.22 [95% CI, −0.40 to 0.03]), motor (antenatal period, r = −0.07 [95% CI, −0.18 to 0.03]; postnatal period, r = −0.07 [95% CI, −0.16 to 0.03]), and adaptive behavior (antenatal period, r = −0.26 [95% CI, −0.39 to −0.12]) development. Findings extended beyond infancy, into childhood and adolescence. Meta-regressions confirmed the robustness of the results. CONCLUSIONS AND RELEVANCE Evidence suggests that perinatal depression and anxiety in mothers are adversely associated with offspring development and therefore are important targets for prevention and early intervention to support mothers transitioning into parenthood and the health and well-being of next-generation offspring.
International Journal of Mental Health Systems, 2014
Background: Maternal psychological health during pregnancy has been associated with offspring psychopathology. However, it is uncertain whether these associations are mediated by the postpartum depression and related child-rearing factors. Therefore, we examined the associations between prenatal and postnatal factors and internalizing and externalizing behavioral problems in childhood, focusing on maternal psychological health in school-aged children in Korea. Findings: The current study included 1,003 children (580 boys, 423 girls, mean age 9.05 ± 0.70 years, age range 8-11 years) recruited from schools in five Korean cities. Children's internalizing and externalizing problems were assessed by the Child Behavior Checklist (CBCL). The parents of the children completed structured questionnaires on perinatal factors. Among 1,003 children, 44 had internalizing problems (IP) and 30 had externalizing problems (EP). When comparing children with IP (n = 44) and without IP (n = 959), severe maternal stress during pregnancy (OR3.36, 95% CI 1.80-6.25) and postpartum depression (OR3.19, 95% CI 1.36-7.53) showed a significant association with the IP. When comparing children with EP (n = 30) and without EP (n = 973), low family income (OR2.19, 95% CI 1.05-4.56), unwanted pregnancy (OR2.76, 95% CI 1.28-5.95) and severe maternal stress during pregnancy (OR2.69, 95% CI 1.29-5.61) with the EP. Only maternal stress during pregnancy was significantly associated with the IP after controlling for postpartum depression and with the EP after controlling for family income and unwanted pregnancy. Conclusion: This study suggests the importance of maternal psychological health during perinatal period on children's mental health. Further prospective studies in a larger sample are required to confirm our findings.
Parents’ Prenatal Mental Health and Emotional, Behavioral and Social Development in Their Children
Child Psychiatry & Human Development, 2014
This study examines the association between expectant parents' psychological distress and children's development at 36 months old. This is a prospective population study based on the Norwegian Mother and Child Cohort Study, N = 31,663. Logistic regression models were used to assess whether high scores (cutoff C2.00) on the symptom checklist-5 in parents predicted higher levels (cutoff C90 percentile) of developmental problems in their children. The risk of emotional and behavioral problems were significantly increased in children when both parents were affected by psychological distress during pregnancy, fully adjusted OR 2.35 (95 % CI 1.36, 4.07) and OR 2.65 (96 % CI 1.564.48), respectively. The risk was higher when mothers reported high level of psychological distress than when only the fathers did, but the risk of emotional difficulties in children was highest when both parents presented high levels of psychological distress, indicating an additive effect of parental psychological distress.
Development and …, 2011
The maternal experience of stressful events during pregnancy has been associated with a number of adverse consequences for behavioral development in offspring, but the measurement and interpretation of prenatal stress varies among reported studies. The Raine Study recruited 2900 pregnancies and recorded life stress events experienced by 18 and 34 weeks' gestation along with numerous sociodemographic data. The mother's exposure to life stress events was further documented when the children were followed-up in conjunction with behavioral assessments at ages 2, 5, 8, 10, and 14 years using the Child Behavior Checklist. The maternal experience of multiple stressful events during pregnancy was associated with subsequent behavioral problems for offspring. Independent (e.g., death of a relative, job loss) and dependent stress events (e.g., financial problems, marital problems) were both significantly associated with a greater incidence of mental health morbidity between age 2 and 14 years. Exposure to stressful events in the first 18 weeks of pregnancy showed similar associations with subsequent total and externalizing morbidity to events reported at 34 weeks of gestation. These results were independent of postnatal stress exposure. Improved support for women with chronic stress exposure during pregnancy may improve the mental health of their offspring in later life.
Association Between Maternal Perinatal Depression and Anxiety and Child and Adolescent Development
JAMA Pediatrics
IMPORTANCE There is widespread interest in associations between maternal perinatal depression and anxiety and offspring development; however, to date, there has been no systematic, meta-analytic review on the long-term developmental outcomes spanning infancy through adolescence. OBJECTIVE To provide a comprehensive systematic review and meta-analysis of the extant literature on associations between maternal perinatal depression and anxiety and social-emotional, cognitive, language, motor, and adaptability outcomes in offspring during the first 18 years of life. DATA SOURCES Six databases were searched (CINAHL Complete, Cochrane Library, Embase, Informit, MEDLINE Complete, and PsycInfo) for all extant studies reporting associations between perinatal maternal mental health problems and offspring development to March 1, 2020. STUDY SELECTION Studies were included if they were published in English; had a human sample, quantitative data, a longitudinal design, and measures of perinatal depression and/or anxiety and social-emotional, cognitive, language, motor, and/or adaptability development in offspring; and investigated an association between perinatal depression or anxiety and childhood development. DATA EXTRACTION AND SYNTHESIS Of 27 212 articles identified, 191 were eligible for meta-analysis. Data were extracted by multiple independent observers and pooled using a fixed-or a random-effects model. A series of meta-regressions were also conducted. Data were analyzed from January 1, 2019, to March 15, 2020. MAIN OUTCOMES AND MEASURES Primary outcomes included social-emotional, cognitive, language, motor, and adaptability development in offspring during the first 18 years of life. RESULTS After screening, 191 unique studies were eligible for meta-analysis, with a combined sample of 195 751 unique mother-child dyads. Maternal perinatal depression and anxiety were associated with poorer offspring social
Prenatal maternal stress: effects on pregnancy and the (unborn) child
Early Human Development, 2002
Background: Animal experiments have convincingly demonstrated that prenatal maternal stress affects pregnancy outcome and results in early programming of brain functions with permanent changes in neuroendocrine regulation and behaviour in offspring. Aim: To evaluate the existing evidence of comparable effects of prenatal stress on human pregnancy and child development. Study design: Data sources used included a computerized literature search of PUBMED (1966PUBMED ( -2001 Psychlit (1987 Psychlit ( -2001; and manual search of bibliographies of pertinent articles. Results: Recent well-controlled human studies indicate that pregnant women with high stress and anxiety levels are at increased risk for spontaneous abortion and preterm labour and for having a malformed or growth-retarded baby (reduced head circumference in particular). Evidence of long-term functional disorders after prenatal exposure to stress is limited, but retrospective studies and two prospective studies support the possibility of such effects. A comprehensive model of putative interrelationships between maternal, placental, and fetal factors is presented. Conclusions: Apart from the well-known negative effects of biomedical risks, maternal psychological factors may significantly contribute to pregnancy complications and unfavourable development of the (unborn) child. These problems might be 0378-3782/02/$ -see front matter D 2002 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 7 8 -3 7 8 2 ( 0 2 ) 0 0 0 7 5 -0 (E.J.H. Mulder). www.elsevier.com/locate/earlhumdev Early Human Development 70 (2002) 3 -14