Parental mental health before and during pregnancy and offspring birth outcomes: A 20-year preconception cohort of maternal and paternal exposure

Abstract

Background Preterm birth (PTB) and small for gestational age (SGA) are increasingly prevalent, with major consequences for health and development into later life. There is emerging evidence that some risk processes begin before pregnancy. We report on associations between maternal and paternal common mental disorders (CMD) before and during pregnancy and offspring PTB and SGA. Methods 398 women with 609 infants and 267 men with 421 infants were assessed repeatedly for CMD symptoms before pregnancy between age 14 and 29 and during pregnancy. Associations between preconception and antenatal CMD symptoms and offspring gestational age/PTB and size for gestational age/SGA were estimated using linear and Poisson regression. Findings In men, persistent preconception CMD across adolescence and young adulthood predicted offspring PTB after adjustment for ethnicity, education, BMI and adolescent substance use (adjusted RR 7·0, 95% CI 1·8,26·8), corresponding to a population attributable fraction of 31% of preterm births. In women, antenatal CMD symptoms predicted offspring PTB (adjusted RR 4·4, 95% CI 1·4,14·1). There was little evidence of associations with SGA. Interpretation This first report of an association between paternal preconception mental health and offspring gestational age, while requiring replication in larger samples, complements earlier work on stress in animals, and further strengthens the case for expanding preconception mental health care to both men and women. Funding National Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation, Murdoch Children's Research Institute, Australian Research Council.

Prevalence of Common Mental Disorders among pregnant women—Evidence from population-based study in rural Haryana, India

“…[ 22 28 29 ] Study by Spry et al ., 2020 found association of CMDs during pregnancy with prematurity but not with low birth weight. [ 40 ] In the present study, we did not find any significant association of CMDs with child health outcomes. Majority of the pregnant women in our study were living in extended family.…”

Preconception Mental Health, Socioeconomic Status, and Pregnancy Outcomes in Primiparous Women

“…Comorbidity is common for mental disorders (7,8). The poor preconception of mental health is a risk factor for both pregnancy complications and adverse health outcomes in the offspring (9)(10)(11)(12)(13)(14).…”

“…Overall, pregnancy complications were identified in four out of ten women (10). Studies, including both primiparous and multiparous women, show that women with preconception common mental disorders (CDM, i.e., depression and anxiety) are more likely to have pregnancy complications, such as gestational diabetes mellitus (GDM), miscarriage or stillbirth, and delivery of a preterm or a low-birthweight newborn (9)(10)(11). A recent systematic review and meta-analysis show that antenatal maternal anxiety was associated with preterm birth and low birthweight, but not with pre-eclampsia, and cesarean delivery (11).…”

“…A recent systematic review and meta-analysis show that antenatal maternal anxiety was associated with preterm birth and low birthweight, but not with pre-eclampsia, and cesarean delivery (11). Most of these studies were from North America and Europe and the adverse outcomes of offspring were associated with socioeconomic characteristics, such as young or old maternal age, smoking, and low education (9)(10)(11). However, the study results are conflicting regarding preconception anxiety and depression and their association with GDM (1,13,15,16).…”

Parental Preconception Exposures to Outdoor Neighbourhood Environments and Adverse Birth Outcomes: A Protocol for a Scoping Review and Evidence Map

“…Most evidence is based on animal models, and a few recent studies suggested that the paternal preconception environment, such as diet and early-life stress or trauma plays a role in foetal development and offspring health outcomes [69][70][71][72][73]. A handful of human studies have shown links between paternal alcohol consumption, smoking and mental health in the preconception period with birth outcomes [66,74,75], although in some cases the evidence is mixed [74]. Several studies have demonstrated that paternal health status is linked with preterm birth and low birth weight in the child, as well as gestational diabetes and preeclampsia in the mother [76,77].…”