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Sridhar H, Kishore MT, Chandra PS. Child developmental outcomes associated with postpartum depression and anxiety in low and middle-income countries: a systematic review. Arch Womens Ment Health 2024:10.1007/s00737-024-01485-7. [PMID: 38896155 DOI: 10.1007/s00737-024-01485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
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.
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Affiliation(s)
- Harikrupa Sridhar
- Department of clinical psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - M Thomas Kishore
- Department of clinical psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Sörensen F, Kimmel MC, Brenner V, Krägeloh-Mann I, Skalkidou A, Mahjani B, Fransson E. Interactions of perinatal depression versus anxiety and infants' early temperament trajectories. Child Dev 2024; 95:721-733. [PMID: 38010823 DOI: 10.1111/cdev.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 11/29/2023]
Abstract
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).
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Affiliation(s)
- Ferdinand Sörensen
- Pediatric Neurology & Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, University Hospital Tübingen, Tübingen, Germany
| | - Mary C Kimmel
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Psychiatry, Center for Women's Mood Disorders, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vera Brenner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Ingeborg Krägeloh-Mann
- Pediatric Neurology & Developmental Medicine, University Children's Hospital Tübingen, Tübingen, Germany
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Behrang Mahjani
- Department of Psychiatry, Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Stockholm, Sweden
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Burger M, Einspieler C, Jordaan ER, Unger M, Niehaus DJH. Persistent Maternal Mental Health Disorders and Toddler Neurodevelopment at 18 Months: Longitudinal Follow-up of a Low-Income South African Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6192. [PMID: 37372776 DOI: 10.3390/ijerph20126192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
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.
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Affiliation(s)
- Marlette Burger
- Faculty of Medicine and Health Sciences, Physiotherapy Division, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town 8000, South Africa
| | - Christa Einspieler
- Research Unit iDN-Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8010 Graz, Austria
| | - Esme R Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town 7500, South Africa
- Statistics and Population Studies, University of the Western Cape, Cape Town 8000, South Africa
| | - Marianne Unger
- Faculty of Medicine and Health Sciences, Physiotherapy Division, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town 8000, South Africa
| | - Dana J H Niehaus
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town 8000, South Africa
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Nielsen-Scott M, Fellmeth G, Opondo C, Alderdice F. Prevalence of perinatal anxiety in low- and middle-income countries: A systematic review and meta-analysis. J Affect Disord 2022; 306:71-79. [PMID: 35306121 DOI: 10.1016/j.jad.2022.03.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/19/2022] [Accepted: 03/10/2022] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Maria Nielsen-Scott
- School of Medicine and Biomedical Sciences, University of Oxford, Oxford, UK
| | - Gracia Fellmeth
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Charles Opondo
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Alderdice
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Shen Q, Huang CR, Rong L, Ju S, Redding SR, Ouyang YQ, Wang R. Effects of needs-based education for prenatal anxiety in advanced multiparas: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:301. [PMID: 35395734 PMCID: PMC8994345 DOI: 10.1186/s12884-022-04620-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/22/2022] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- Quan Shen
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Can-Ran Huang
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Liu Rong
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Shan Ju
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China
| | | | - Yan-Qiong Ouyang
- School of Nursing, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Rong Wang
- Nursing Department of East Campus, Renming Hospital of Wuhan University, Gaoxin Sixth Road, Jiangxia District, Wuhan, 430071, China.
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Paula AJD, Condeles PC, Moreno AL, Ferreira MBG, Fonseca LMM, Ruiz MT. Parental burnout: a scoping review. Rev Bras Enferm 2021; 75Suppl. 3:e20210203. [PMID: 34852152 DOI: 10.1590/0034-7167-2021-0203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/29/2021] [Indexed: 02/27/2024] Open
Abstract
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).
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Affiliation(s)
- Ana Júlia de Paula
- Universidade Federal do Triângulo Mineiro. Uberaba, Minas Gerais, Brazil
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