Infant temperament and perinatal depressive and anxiety symptoms in Mexican women

Child developmental outcomes associated with postpartum depression and anxiety in low and middle-income countries: a systematic review

AIMS

This systematic review aims to summarize the findings of empirical studies conducted in low- and middle-income countries (LMICs) examining the relationship between postpartum depression and anxiety, and child developmental outcomes measured at 24 months of child's age.

METHODS

The study was performed as per PRISMA guidelines for a systematic review. EBESCO, ProQuest, PubMed, Science Direct, Google Scholar, and BMJ databases were examined, along with a forward and backward examination of the citations published. The New Ottawa scales (NOS) was used to assess the quality of the studies. The findings of the studies were integrated using a narrative synthesis approach.

RESULTS

The systematic review revealed that there are 14 studies examining the impact of postpartum depression (n=14) and postpartum anxiety (n=2) across different domains of child development in LMICs. Studies varied regarding the severity and duration of maternal depression, the context and nature of evaluation, and motherinfant characteristics which are important to understand the association between postpartum depression and anxiety and infant development. Maternal depression is negatively associated with language development, socio-emotional and behavioural development while its association with motor and cognitive development is inconsistent. The impact of maternal anxiety on infant development was examined in two studies, and both have identified a negative association. However, the results of the current review need to be interpreted within the scope and limitations of the methodologies adopted by each study details of which are elaborated in the manuscript.

CONCLUSION

Postpartum depression and anxiety can have a wide range of effects on child development. Therefore, periodic infant developmental assessments should become part of routine psychiatric evaluation. There is a need for uniform guidelines for conducting studies and reporting data related to postpartum mental health and child development.

Interactions of perinatal depression versus anxiety and infants' early temperament trajectories

This study examines the interplay between maternal depression/anxiety and infant temperament's developmental trajectory in 1687 Swedish-speaking mother-infant dyads from Uppsala County (2009-2019), Sweden. The sample includes a high proportion of university-educated individuals and a low share of foreign-born participants. Maternal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale during gestational weeks 17 and 32 and postpartum at week 6. Multinomial regression explored associations between maternal variables and infant temperament trajectories at 6 weeks, 12 months, and 18 months. Prenatal anxiety is associated with the high-rising infant difficult temperament trajectory, while prenatal depression/anhedonia is associated with the stable-medium trajectory, attenuated postpartum. Associations between infant temperament and maternal mood depended on timing (pre/postpartum) and symptom type (depression/anhedonia vs. anxiety).

Persistent Maternal Mental Health Disorders and Toddler Neurodevelopment at 18 Months: Longitudinal Follow-up of a Low-Income South African Cohort

One of the biggest threats to early childhood development in Africa is poor maternal mental health. The present study reports on the relationships between clinical diagnoses of persistent maternal mental health disorders (at 3- and/or 6- and 18-month post-term age) and toddler neurodevelopment at 18 months of age. Eighty-three mother-toddler dyads from low socio-economic status settings in Cape Town, South Africa, were included. At the 3-, 6- and 18-month postnatal visits, clinician-administered structured diagnostic assessments were carried out according to the Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria. Toddler neurodevelopment at 18 months corrected age was assessed with the Bayley Scales of Infant and Toddler Development (BSID-III). No significant differences (p > 0.05) were found between toddlers with exposure to persistent mood or psychotic disorders in the different BSID-III domains compared to toddlers with no exposure. Toddlers exposed to persistent comorbid anxiety and mood disorders scored significantly higher on the cognitive (p = 0.049), motor (p = 0.013) and language (p = 0.041) domains and attained significantly higher fine motor (p = 0.043) and gross motor (p = 0.041) scaled scores compared to toddlers with no maternal mental health disorder exposure. Future investigations should focus on the role of protective factors to explain the pathways through which maternal mental health status is associated with positive toddler neurodevelopmental outcomes.

Prevalence of perinatal anxiety in low- and middle-income countries: A systematic review and meta-analysis

BACKGROUND

Perinatal anxiety is associated with adverse outcomes for women and their infants. Women in low- and middle-income countries (LMIC) may be at higher risk of perinatal anxiety. We aimed to systematically review and synthesise the evidence on prevalence of perinatal anxiety in LMIC.

METHOD

We searched MEDLINE, Embase, PscyhINFO, Global Health and Web of Science to identify studies assessing prevalence of perinatal anxiety in LMIC. Studies published since January 2016 were included. Screening and data extraction was conducted independently by two reviewers. Pooled prevalence estimates were calculated using random-effect meta-analyses and sources of heterogeneity explored through subgroup analyses and meta-regression.

RESULTS

We screened 9494 titles and abstracts, reviewed 700 full-texts and included 54 studies in the systematic review and meta-analysis. The pooled prevalence of self-reported anxiety symptoms was 29.2% (95%CI 24.5-34.2; I² 98.7%; 36 studies; n = 28,755) antenatally and 24.4% (95%CI 16.2-33.7; I² 98.5%; 15 studies; n = 6370) postnatally. The prevalence of clinically-diagnosed anxiety disorder was 8.1% (95%CI 4.4-12.8; I² 88.1% 5 studies; n = 1659) antenatally and 16.0% (95% CI 13.5-18.9; n = 113) postnatally.

LIMITATIONS

Our search was limited to studies published since January 2016 in order to update a previous review on this topic.

CONCLUSION

Perinatal anxiety represents a significant burden in LMIC, with one in four women experiencing symptoms during pregnancy or postpartum. Research remains lacking in a significant proportion of LMIC, particularly in the lowest income countries. Further research should guide application of screening tools in clinical settings to identify women with anxiety disorders in order to provide appropriate treatment.

Effects of needs-based education for prenatal anxiety in advanced multiparas: a randomized controlled trial

Background

Prenatal anxiety is a common concern which may have adverse effects on maternal and infant health outcomes. Studies addressing needs-based education interventions for prenatal anxiety are limited.

Aim

To explore the effects of needs-based education on alleviating prenatal anxiety among advanced multiparas when compared with routine prenatal health education.

Methods

A total of 86 advanced multiparas were randomized into the intervention group (n = 43) or the control group (n = 43) in this study. The control group received routine prenatal care. The intervention group received five needs-based education programs presented by trained researchers. The Pregnancy-related Anxiety Questionnaire was used to evaluate changes in anxiety level of participants. Concurrent physiological parameters, including blood pressure, heart rate and non-stress test were also measured.

Results

Scores on the Pregnancy-related Anxiety Questionnaire of the intervention group were significantly lower than those of the control group (t = 4.21, P < 0.05). Systolic blood pressure (t = 3.64, P < 0.05) and heart rate (t = 2.39, P < 0.05) of the intervention group were also significantly lower than the control group whereas no differences were noted in diastolic blood pressure and non-stress test.

Conclusion

A needs-based education program is an effective intervention strategy to allay prenatal anxiety in advanced multiparas.

Trial registration

The trial was retrospectively registered in the Chinese Clinical Trial Registry as number ChiCTR2100047552.

Parental burnout: a scoping review

OBJECTIVE

to map available evidence on parental burnout theme.

METHOD

scoping review as according to the Joanna Briggs Institute. Search in January 2021, in six databases of publications in English, Portuguese or Spanish, without time limits. Data extracted and descriptively analyzed by three independent researchers.

RESULTS

374 articles were identified and 20 were included in the final sample, all published in English, from 2017 onwards. Parental burnout is a complex, multifactorial problem, distinct from burnout cases, depressive symptoms and other mental health alterations. It affects 0.2 to 20% of parents, has validated and suitable instruments for measurement; if not treated, can have consequences on marital life, work relationships, child neglect and violence.

CONCLUSIONS

this is a recent theme that needs to be explored, due to the possible impact on children's and families' health and on parents' work processes. Protocol registered in the Open Science Framework (https://osf.io/jd7vk).