Depression is the most common mental disorder during pregnancy, with prevalence rates between 4% and 20%. The objective of this review was to synthesize the literature on the association between antenatal depression and offspring birth outcomes, as well as developmental, behavioral, and psychiatric outcomes.
Methods
A search of PubMed, Cochrane, and Medline databases was conducted for articles published until December 2017. Articles focusing on the effects of antenatal depression on the offspring were selected to be reviewed. Reference lists of all studies were examined for any missed articles. A total of 32 articles were included in this review.
Results
Antenatal depression is associated with preterm birth, excessive infant crying, and offspring mental health problems. Untreated antenatal depression is strongly associated with adverse effects on the infant nervous system.
Conclusion
Antenatal depression increases the likelihood of poor offspring health outcomes. Research should investigate whether medication use confounds this relationship.
AjinkyaSJadhavPRSrivastavaNN.Depression during pregnancy: prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai. Ind Psychiatry J2013;
22: 37–40.
2.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.
Washington, DC:
American Psychiatric Association, 1995.
3.
WatersCSHayDFSimmondsJR, et al.
Antenatal depression and children’s developmental outcomes: potential mechanisms and treatment options. Eur Child Adolesc Psychiatry2014;
23: 957–971.
4.
Graignic-PhilippeRDayanJChokronS, et al.
Effects of antenatal stress on fetal and child development: a critical literature review. Neurosci Biobehav Rev2014;
43: 137–162.
5.
O'ConnorTGHeronJGoldingJ, et al.
Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years: report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry2002;
180: 502–508.
6.
DavisEPSnidmanNWadhwaPD, et al.
maternal anxiety and depression predict negative behavioral reactivity in infancy. Infancy2004;
6: 319–331.
7.
BenediktssonRSecklJR.Understanding human parturition. Lancet1998;
351: 913–914.
8.
GloverV.Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol2014;
28: 25–35.
9.
WelbergLAMThrivikramanKVPlotskyPM.Chronic maternal stress inhibits the capacity to up-regulate placental 11beta-hydroxysteroid dehydrogenase type 2 activity. J Endocrinol2005;
186: 7–12.
10.
WadhwaPDSandmanCAGariteTJ.The neurobiology of stress in human pregnancy: implications for prematurity and development of the fetal central nervous system. Prog Brain Res2001;
133: 131–142.
11.
BlekerLSRoseboomTJVrijkotteTG, et al.
Determinants of cortisol during pregnancy – the ABCD cohort. Psychoneuroendocrinology2017;
83: 172–181.
12.
OrtaORGelayeBBainPA, et al.
The association between maternal cortisol and depression during pregnancy, a systematic review. Arch Womens Ment Health2018;
21: 43–53.
13.
CherakSJGiesbrechtGFMetcalfeA, et al.
The effect of gestational period on the association between maternal antenatal salivary cortisol and birth weight: a systematic review and meta-analysis. Psychoneuroendocrinology2018;
94: 49–62.
14.
CampbellESeabrookJ.The influence of socioeconomic status on adverse birth outcomes. Can J Midwifery Res Pract2016;
15: 10–20.
15.
GodfreyKMBarkerDJ.Fetal programming and adult health. Public Health Nutr2001;
4: 611–624.
16.
WoodsNGillilandJSeabrookJA.The influence of the built environment on adverse birth outcomes. J Neonatal Perinatal Med2017;
10: 233–248.
17.
KwonEJKimYJ.What is fetal programming?: a lifetime health is under the control of in utero health. Obstet Gynecol Sci2017;
60: 506–519.
18.
DayanJCreveuilCMarksMN, et al.
Antenatal depression, antenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med2006;
68: 938–946.
19.
LiDLiuLOdouliR.Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study. Hum Reprod2009;
24: 146–153.
20.
IbanezGCharlesMAForhanA, et al.
Depression and anxiety in women during pregnancy and neonatal outcome: data from the EDEN mother-child cohort. Early Hum Dev2012;
88: 643–649.
21.
GroteNKBridgeJAGavinAR, et al.
A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry2010;
67: 1012.
22.
PrinceMPatelVSaxenaS, et al.
No health without mental health. Lancet2007;
370: 859–877.
23.
Lugo-CandelasCChaJHongS, et al.
Associations between brain structure and connectivity in infants and exposure to selective serotonin reuptake inhibitors during pregnancy. JAMA Pediatr2018;
172: 525–533.
24.
CharroisTL.Systematic reviews: what do you need to know to get started?Can J Hosp Pharm2015;
68: 144–148.
25.
SimonS.Statistical evidence in medical trials: what do the data really tell us?
New York, USA:
Oxford University Press, 2006.
26.
GentileSFuscoML.Placental and fetal effects of antenatal exposure to antidepressants or untreated maternal depression. J Matern Fetal Neonatal Med2017;
30: 1189–1199.
27.
OrnoyAWeinstein-FudimLErgazZ.Antidepressants, antipsychotics, and mood stabilizers in pregnancy: what do we know and how should we treat pregnant women with depression. Birth Defects Res2017;
109: 933–956.
28.
MezzacappaALasicaPAGianfagnaF.Risk for autism spectrum disorders according to period of antenatal antidepressant exposure: a systematic review and meta-analysis. JAMA Pediatr2017;
171: 555–563.
29.
SangerCIlesJEAndrewCS, et al.
Associations between postnatal maternal depression and psychological outcomes in adolescent offspring: a systematic review. Arch Womens Ment Health2015;
18: 147–162.
30.
FieldT.Antenatal depression effects on early development: a review. Infant Behav Dev2011;
34: 1–14.
31.
GrigoriadisSVonderPortenEHMamisashviliL, et al.
The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry2013;
74: e321–e341.
32.
Valero De BernabéJSorianoTAlbaladejoR, et al.
Risk factors for low birth weight: a review. Eur J Obstet Gynecol Reprod Biol2004;
116: 3–15.
33.
BrouwerMEWilliamsADVan GrinsvenSE, et al.
Offspring outcomes after antenatal interventions for common mental disorders: a meta-analysis. BMC Med2018;
16: 208.
34.
DayanJCreveuilCHerlicoviezM, et al.
Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol2002;
155: 293–301.
35.
YonkersKASmithMVForrayA, et al.
Pregnant women with posttraumatic stress disorder and risk of preterm birth. JAMA Psychiatry2014;
71: 897–904.
36.
MugliaLJKatzM.The enigma of spontaneous preterm birth. N Engl J Med2010;
362: 529–535.
37.
SeabrookJAWoodsNClarkA, et al.
The association between alcohol outlet accessibility and adverse birth outcomes: a retrospective cohort study. J Neonatal Perinatal Med2018;
11: 71–77.
38.
StanevaAAMorawskaABogossianF, et al.
Maternal psychological distress during pregnancy does not increase the risk for adverse birth outcomes. Women Health2018;
58: 92–111.
39.
ChangHYKeyesKMLeeK-S, et al.
Antenatal maternal depression is associated with low birth weight through shorter gestational age in term infants in Korea. Early Hum Dev2014;
90: 15–20.
40.
FieldTDiegoMHernandez-ReifM, et al.
Chronic antenatal depression and neonatal outcome. Int J Neurosci2008;
118: 95–103.
41.
KrauseLEinsleFPetzoldtJ, et al.
The role of maternal anxiety and depressive disorders prior to and during pregnancy and perinatal psychopathological symptoms for early infant diseases and drug administration. Early Hum Dev2017;
109: 7–14.
42.
BanLGibsonJEWestJ, et al.
Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. Bjog: Int J Obstet Gynaecol2014;
121: 1471–1481.
43.
ErtelKAKoenenKCRich-EdwardsJW, et al.
Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatr Perinat Epidemiol2010;
24: 179–189.
44.
RaposaEHammenCBrennanP, et al.
The long-term effects of maternal depression: early childhood physical as a pathway to offspring depression. J Adolesc Health2014;
54: 88–93.
45.
DiegoMAFieldTHernandez-ReifM.Prepartum, postpartum and chronic depression effects on neonatal behavior. Infant Behav Dev2005;
28: 155–164.
46.
O’ConnorTGCaprarielloPBlackmoreER, et al.
Antenatal mood disturbance predicts sleep problems in infancy and toddlerhood. Early Hum Dev2007;
83: 451–458.
47.
de BruijnAvan BakelHJAvan BaarAL.Sex differences in the relation between antenatal maternal emotional complaints and child outcome. Early Hum Dev2009;
85: 319–324.
48.
PawlbySHayDFSharpD, et al.
Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community-based study. J Affect Disord2009;
113: 236–243.
49.
CapronLEGloverVPearsonRM, et al.
Associations of maternal and paternal antenatal mood with offspring anxiety disorder at age 18 years. J Affect Disord2015;
187: 20–26.
50.
PearsonRMEvansJKounaliD, et al.
Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at 18 years. JAMA Psychiatry2013;
70: 1312–1319.
51.
Van der WalMFVan EijsdenMBonselGJ.Stress and emotional problems during pregnancy and excessive infant crying. J Dev Behav Pediatr2007;
28: 431–437.
52.
HuotRLBrennanPAStoweZN, et al.
Negative affect in offspring of depressed mothers is predicted by infant cortisol levels at 6 months and maternal depression during pregnancy, but not postpartum. Ann New York Acad Sci2004; 234–236.
53.
HayDFMundyLRobertsS, et al.
Known risk factors for violence predict 12-month-old infants’ aggressiveness with peers. Psychol Sci2011;
22: 1205–1211.
54.
FieldTDiegoMHernandez-ReifM, et al.
Sleep disturbances in depressed pregnant women and their newborns. Infant Behav Dev2007;
30: 127–133.
55.
NetsiEEvansJWulffK, et al.
Infant outcomes following treatment of antenatal depression: findings from a pilot randomized controlled trial. J Affect Disord2015;
188: 252–256.
56.
FieldTDiegoMDieterJ, et al. Antenatal
depression effects on the fetus and the newborn. Infant Behav Dev2004;
27: 216–229.
57.
FieldTDiegoMHernandez-ReifM.Depressed mothers’ infants are less responsive to faces and voices. Infant Behav Dev2009;
32: 239–244.
58.
HayesLJGoodmanSHCarlsonE.Maternal antenatal depression and infant disorganized attachment at 12 months. Attach Hum Dev2013;
15: 133–153.
59.
TharnerALuijkMPCvan IjzendoornMH, et al.
Maternal lifetime history of depression and depressive symptoms in the antenatal and early postnatal period do not predict infant-mother attachment quality in a large, population-based Dutch cohort study. Attach Hum Dev2012;
14: 63–81.
60.
TandonMCardeliELubyJ.Internalizing disorders in early childhood: a review of depressive and anxiety disorders. Child Adolesc Psychiatr Clin N Am2009;
18: 593–610.
61.
SeabrookJAAvisonWR.Genotype–environment interaction and sociology: contributions and complexities. Soc Sci Med2010;
70: 1277–1284.
62.
SeabrookJAAvisonWR.Socioeconomic status and cumulative disadvantage processes across the life course: implications for health outcomes. Can Rev Sociol2012;
49: 50–68.
63.
AvisonWR.The impact of mental illness on the family. In: AneshenselCSPhelanJC (eds) Handbook of the sociology of mental health.
New York:
Plenum Press, 1999, pp.495–515.
64.
LuomaITamminenTKaukonenP, et al.
Longitudinal study of maternal depressive symptoms and child well-being. J Am Acad Child Adolesc Psychiatry2001;
40: 1367–1374.
65.
HanniganLJEilertsenEMGjerdeLC, et al.
Maternal antenatal depressive symptoms and risk for early-life psychopathology in offspring: genetic analyses in the Norwegian Mother and Child Birth Cohort Study. Lancet Psychiatry2018;
5: 808–815.
66.
ZohselKHolzNEHohmE, et al.
Fewer self-reported depressive symptoms in young adults exposed to maternal depressed mood during pregnancy. J Affect Disord2017;
209: 155–162.
67.
GerardinPWendlandJBodeauN, et al.
Depression during pregnancy: is the developmental impact earlier in boys? A prospective case-control study. J Clin Psychiatry2011;
72: 378–387.
68.
QuariniCPearsonRMSteinA, et al.
Are female children more vulnerable to the long-term effects of maternal depression during pregnancy?J Affect Disord2016;
189: 329–335.
69.
NivardMGDolanCVKendlerKS, et al.
Stability in symptoms of anxiety and depression as a function of genotype and environment: a longitudinal twin study from age 3 to 63 years.Psychol Med2015;
45: 1039–1041.
70.
LundyBLJonesNAFieldT, et al.
Antenatal depression effects on neonates. Infant Behav Dev1999;
22: 119–129.
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