Maternal Mental Health in Pregnancy and Child Behavior

By Satyanarayana, Veena; Lukose, Ammu et al. | Indian Journal of Psychiatry, October-December 2011 | Go to article overview

Maternal Mental Health in Pregnancy and Child Behavior


Satyanarayana, Veena, Lukose, Ammu, Srinivasan, K., Indian Journal of Psychiatry


Byline: Veena. Satyanarayana, Ammu. Lukose, K. Srinivasan

Maternal mental health research is a public health priority due to its impact on both maternal and child health. Despite the growing number of empirical studies in this area, particularly from developing countries, there is a paucity of synthetic review articles. Therefore, attempting to synthesize the existing literature in this area seems relevant to appraise the readers of the field's progress and to infer directions for future research. The present review aims to provide an overview of the literature on maternal mental health and its association with birth outcomes and child behavior. Specifically, the literature on mental health during pregnancy and in the postpartum period and its influence on birth outcomes and child behavior have been reviewed. Further, a conceptual and methodological evaluation of the existing literature has been provided to identify gaps in the literature and to suggest directions for future research.

Introduction

With declining rates of maternal mortality worldwide, researchers are recognizing the importance of addressing morbidity as well. The contribution of maternal mental health to maternal morbidity however has not been well ascertained. [sup][1] In recent decades, psychological morbidity in child-bearing women in particular has received increasing research attention because of its ramifications on the mother as well as her child.

Once considered a time of emotional wellbeing, and "protecting" women against psychiatric disorders, it is now well established that several psychiatric disorders are common during pregnancy, with depression being the most common. [sup][2] Violence during pregnancy or intimate partner violence has also received research attention due to its lasting consequences on the mental health and wellbeing of the mother and her child. Further, motherhood is often glorified, which makes the pregnant woman or mother feel guilty about experiencing negative emotions.

For the purpose of the present review, we limit our focus to reviewing published reports on common mental disorders, such as depression and anxiety disorders, and general psychological distress during pregnancy and in the postpartum period. Research has indicated that risk factors for poor mental health during pregnancy include past personal or family history of psychiatric illness or substance abuse, past personal history of sexual, physical or emotional abuse, current exposure to intimate partner violence or coercion, current social adversity and coincidental adverse life events. Psychological disturbances during pregnancy are associated with inadequate antenatal care, low-birth weight and preterm delivery, while in the postpartum, it is associated with diminished emotional involvement, neglect and hostility towards the newborn. While the bulk of literature in this area is from the developed world, particularly, the United States, Canada, Europe and Australia, the last decade has seen some interesting publications from developing countries as well where gender disadvantage, poverty and limited access to resources further complicate the issue.

An attempt has been made to synthesize literature on maternal mental health and child behavior in the last 5 years. Although mental health of mothers in the postpartum period is relatively well researched compared with mental health during pregnancy, empirical studies on the impact of either on infant/child behavior and development is still in its infancy. Cultural preferences and culture-specific issues in the manifestation of psychological distress during pregnancy have been elucidated as well.

Antenatal Mental Health

The perinatal period, which includes both antenatal and postnatal phases, is very significant both for the mother as well as for her child. Although the impact of maternal mental health on child development starts from conception, research in the area of antenatal mental health has gained momentum only in recent years. …

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