Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences

Abstract

Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents’ behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.

Perinatal mental health: a review of progress and challenges

“…There is a large evidence base on associations between perinatal mental disorders and childhood adverse mental health outcomes, particularly for perinatal depression 58 and antenatal alcohol misuse 59 . The association between prenatal alcohol exposure and childhood cognitive impairment is not only supported by observational data, but also by at least one randomized controlled trial (RCT) and 16 quasi‐experimental studies (including nine Mendelian randomization studies and seven “natural experiment” studies) 60 .…”

The Long-Term Impact of Maternal Anxiety and Depression Postpartum and in Early Childhood on Child and Paternal Mental Health at 11–12 Years Follow-Up

“…From a developmental psychopathology perspective, a complex and dynamic interplay of psychological, social and biological mechanisms has been suggested to underlie the associations of maternal postpartum depression and anxiety with child mental health (17,18). Next to environmental mediation, previous research indicated that genetic mediation plays, at least partly, a role in the intergenerational transmission of both depression and anxiety (19)(20)(21)(22)(23).…”

“We do not know how to screen and provide treatment”: A qualitative study of barriers and enablers of implementing perinatal depression health services in Ethiopia

“…In Ethiopia, the prevalence of antenatal depression ranges from 11% to 31% (3), while the prevalence of postnatal depression ranges from 12 to 33% (4,5). Untreated depression during pregnancy has been reported to increase the risk of obstetric complications (6), poor foetal growth (7,8), and adverse birth outcomes (1,2). Similarly, untreated postnatal depression is reported to increase the risk of adverse infant health outcomes (9,10) and their future educational achievement (11).…”