Maternal perinatal mental health and infant and toddler neurodevelopment - Evidence from low and middle-income countries. A systematic review

Burger, Marlette; Hoosain, Munira; Einspieler, Christa; Unger, Marianne; Niehaus, Dana J.H.

doi:10.1016/j.jad.2020.03.023

Cited by 50 publications

(37 citation statements)

References 51 publications

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“…They may also experience thoughts of poor self-esteem, self-harm, and suicidal ideation and thoughts about harming the child [ 8 ]. Children born to mothers with perinatal anxiety and depression often report poor cognitive, motor and language development, behavioral disorders, and poor academic performance [ 9 , 10 ]. These conditions are also associated with high infant infection rates and hospitalizations and have a higher risk of preterm birth, low birth weight and poor physical growth [ 3 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence

et al. 2022

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Postpartum depression and anxiety are highly prevalent worldwide. Fisher et al., estimated the prevalence of depression and anxiety at 15.6% during the antenatal and 19.8% during the postpartum period. Their impact on maternal and child health is well-recognized among the public health community, accounting for high societal costs. The public health impact of these conditions has highlighted the need to focus on the development and provision of effective prevention and treatment strategies.In recent decades, some advances have been made in the development of effective universal and targeted screening programmes for perinatal depression and anxiety disorders. Recent research has shown potential benefits of universal and targeted screening for perinatal depression, to identify and treat undiagnosed cases, and help thwart its deleterious consequences. Ethical implications, however, for these screening programmes, without the provision of treatment have often been emphasized.The present mixed-methods systematic review and meta-analysis was conducted to collate evidence for screening programmes for perinatal depression and anxiety. It aims to answer the following questions, in a global context: For women in the perinatal period, do screening programmes for perinatal depression and anxiety compared with no screening improve maternal mental health and infant outcomes?A series of meta-analyses reveal a reduction in perinatal depression and anxiety among perinatal women undergoing screening programmes. For the outcome of depressive disorder, meta-analysis indicates a positive impact in favour of the intervention group (OR = 0.55, 95% CI: 0.45 to 0.66, n = 9009), with moderate quality of evidence. A significant improvement (high quality) was also observed in symptoms of anxiety among perinatal women (SMD = − 0.18, 95% CI: − 0.25 to − 0.12, n = 3654).

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Section: Introductionmentioning

confidence: 99%

Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence

et al. 2022

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“…While a number of broader systematic reviews have included the relationship between perinatal depression and cognitive development in LMIC settings [ 24 – 27 ], there has not yet been a focused synthesis of studies on perinatal depression and cognitive development conducted in the LMIC context. A recent systematic review of studies examining the impact of perinatal mental health on infant neurodevelopment in LMIC settings [ 28 ] included both a wide range of perinatal mental health disorders (e.g. schizophrenia, mania, PTSD, anxiety, depression) which may have very distinct effects on infant development, and a wide range of child outcomes to age 2 (gross and fine motor, cognitive, language, behavior and social-emotional development).…”

Section: Introductionmentioning

confidence: 99%

“…The narrative synthesis therefore did not provide an in-depth evaluation of the evidence for effects of perinatal depression per se on cognitive development specifically. The authors concluded “Due to heterogeneity of reported types of maternal health disorders and different domains of developmental outcomes, it was not possible to draw a definitive conclusion about the association between prenatal exposure to maternal mental health and child development” [ 28 , p. 168].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the association between perinatal depression and cognitive development in infancy in low and middle-income countries

et al. 2021

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The association between perinatal depression and infant cognitive development has been well documented in research based in high-income contexts, but the literature regarding the same relationship in low and middle-income countries (LMICs) is less developed. The aim of this study is to systematically review what is known in this area in order to inform priorities for early intervention and future research in LMICs. The review protocol was pre-registered on Prospero (CRD42018108589) and relevant electronic databases were searched using a consistent set of keywords and 1473 articles were screened against the eligibility criteria. Sixteen articles were included in the review, seven focusing on the antenatal period, eight on the postnatal period, and one which included both. Five out of eight studies found a significant association between antenatal depression (d = .21-.93) and infant cognitive development, while four out of nine studies found a significant association with postnatal depression (d = .17-.47). Although the evidence suggests that LMICs should prioritise antenatal mental health care, many of the studies did not adequately isolate the effects of depression in each period. Furthermore, very few studies explored more complex interactions that may exist between perinatal depression and other relevant factors. More high-quality studies are needed in LMIC settings, driven by current theory, that test main effects and examine moderating or mediating pathways to cognitive development.

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“…Other environmental exposures such as antibiotics administration during pregnancy, in the first months of life, childhood or adolescence may also strongly impact gut microbiota colonization and determine neurocognitive impairments later in life ( 39 – 41 , 50 ). A recent study on the effects of 3-weeks microbiota depletion in antibiotic-treated mice reported that transient microbiota depletion during adolescence, a particularly vulnerable time for gut microbiota composition and when the brain is highly responsive to certain environmental factors, has long-lasting effects on microbiota composition and increases anxiety-like behavior; however, this was not the case in adulthood ( 51 ).…”

Section: Impact Of Early Life Enviromental Factors On Gut Micriobiota and Neurodevelopment: Key Role Of Dietmentioning

confidence: 99%

Towards Tailored Gut Microbiome-Based and Dietary Interventions for Promoting the Development and Maintenance of a Healthy Brain

et al. 2021

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Mental health is determined by a complex interplay between the Neurological Exposome and the Human Genome. Multiple genetic and non-genetic (exposome) factors interact early in life, modulating the risk of developing the most common complex neurodevelopmental disorders (NDDs), with potential long-term consequences on health. To date, the understating of the precise etiology underpinning these neurological alterations, and their clinical management pose a challenge. The crucial role played by diet and gut microbiota in brain development and functioning would indicate that modulating the gut-brain axis may help protect against the onset and progression of mental-health disorders. Some nutritional deficiencies and gut microbiota alterations have been linked to NDDs, suggesting their potential pathogenic implications. In addition, certain dietary interventions have emerged as promising alternatives or adjuvant strategies for improving the management of particular NDDs, at least in particular subsets of subjects. The gut microbiota can be a key to mediating the effects of other exposome factors such as diet on mental health, and ongoing research in Psychiatry and Neuropediatrics is developing Precision Nutrition Models to classify subjects according to a diet response prediction based on specific individual features, including microbiome signatures. Here, we review current scientific evidence for the impact of early life environmental factors, including diet, on gut microbiota and neuro-development, emphasizing the potential long-term consequences on health; and also summarize the state of the art regarding the mechanisms underlying diet and gut microbiota influence on the brain–gut axis. Furthermore, we describe the evidence supporting the key role played by gut microbiota, diet and nutrition in neurodevelopment, as well as the effectiveness of certain dietary and microbiome-based interventions aimed at preventing or treating NDDs. Finally, we emphasize the need for further research to gain greater insight into the complex interplay between diet, gut microbiome and brain development. Such knowledge would help towards achieving tailored integrative treatments, including personalized nutrition.

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Maternal perinatal mental health and infant and toddler neurodevelopment - Evidence from low and middle-income countries. A systematic review

Cited by 50 publications

References 51 publications

Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence

Screening programs for common maternal mental health disorders among perinatal women: report of the systematic review of evidence

A systematic review of the association between perinatal depression and cognitive development in infancy in low and middle-income countries

Towards Tailored Gut Microbiome-Based and Dietary Interventions for Promoting the Development and Maintenance of a Healthy Brain

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