Mental Health during Pregnancy: The Impact of Prenatal Maternal Mental Health on the Child

The journey of motherhood is known to be bridled with numerous challenges for the mother - motherhood can be a taxing journey both physically and mentally. Whilst many believe that the challenges arise with arrival of the infant, maternal mental health concerns preceding birth are also many and complex. It is important to understand that these prenatal maternal mental health concerns are valid and concerning in and of themselves. Beyond this, exploring the far-reaching impact on the infant allows for a glimpse of the urgency of bringing these concerns to light. It also makes way for making efforts to address them in their earliest stages.

Mental health concerns like anxiety and depression with an onset in pregnancy are extremely common. Such mental adversities along with maternal experiences of life stressors in pregnancy have been documented to predict both emotional and behavioral problems in children. These negative influences on children have been recorded from birth, through infancy, childhood, and even well into adulthood.

At the outset, prenatal maternal depression has been found to be associated with premature deliveries and lower recorded birth weights. The trajectory of fetal growth has also been documented to be stunted in mothers who show depressive symptoms prenatally. There is also an impact on the levels of various hormones in the child’s body - namely, elevated cortisol and norepinephrine have been noted, which indicate that the infant is more prone to stress and anxiety. The levels of neurotransmitters (a chemical in the nervous system) like dopamine (impacts the experiences of pleasure and happiness) are also found to be lowered (Davalos, Yadon, & Tregellas, 2012).

Prenatal maternal issues have also been linked to the development of the child’s temperament, which is the biologically-based component of personality. Temperament can be understood as the foundation on which an individual’s personality develops later in life. Studies document that mental health challenges faced by mothers prenatally correlate to the child developing a ‘difficult’ temperament, which is characterized by irregular bodily functions, withdrawal from new situations, slow adaptability, negative mood, and intense reactions. These infants were found to experience higher levels of distress and spent lesser time smiling. The implications of the impact on temperament is especially significant due to its long-lasting consequences. For instance, a difficult temperament increases the child’s probability of developing a mental disorder later in life, including depression, anxiety, and attention deficit/ hyperactivity disorder. Temperament has also been found to greatly influence the mother’s wellbeing, and the quality of the mother-infant relationship, which lays the ground for various important interactions in the child’s life (Erickson, Gartstein, & Dotson, 2017).

The impact of disturbed maternal mental health due to severe life stressors is one area that has been well explored in research literature. Such a state of maternal mental health has been linked to the development of various serious mental health conditions. One dramatic documentation of such effects is a landmark, long-term study conducted in The Netherlands (Van Os, & Selten, 1998). The study followed expectant mothers exposed to the May 1940 invasion and defeat of The Netherlands by the German army, which was considered a highly stressful event. The study recorded that exposure to the stressor, especially in the first trimester of pregnancy, was associated with a higher incidence of development of schizophrenia in children.

Grapples with mental health are challenging for an individual, regardless of what phase of life they are in, and such is the case with mothers too. But beyond this individual morbidity, as the above brief discussion showed, maternal mental health issues have significant, severe, and long-term consequences for their children - this might further contribute to poorer mental health outcomes in the mothers. The situation can be made less grim, however, if these mental health issues are given the attention they deserve and treated psychologically and pharmacologically. Hence, it is all the more important to recognize the gravity of prenatal maternal mental health issues, and contribute to a more fulfilling motherhood.

References:

1. Davalos, D. B., Yadon, C. A., & Tregellas, H. C. (2012). Untreated prenatal maternal depression and the potential risks to offspring: a review. Archives of Women’s Mental Health, 15(1), 1–14. doi:10.1007/s00737-011-0251-1

2. Erickson, N. L., Gartstein, M. A., & Dotson, J. A. W. (2017). Review of Prenatal Maternal Mental Health and the Development of Infant Temperament. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(4), 588–600. doi:10.1016/j.jogn.2017.03.008

3. Howland, M. A., Sandman, C. A., Davis, E. P., & Glynn, L. M. (2020). Prenatal maternal psychological distress and fetal developmental trajectories: Associations with infant temperament. Development and Psychopathology, 32(5), 1685-1695.

4. Lewis, A. J., Austin, E., & Galbally, M. (2016). Prenatal maternal mental health and fetal growth restriction: a systematic review. Journal of Developmental Origins of Health and Disease, 7(04), 416–428. doi:10.1017/s2040174416000076

5. Van Os, J., & Selten, J. P. (1998). Prenatal exposure to maternal stress and subsequent schizophrenia. The British Journal of Psychiatry, 172(4), 324-326. doi: 10.1192/bjp.172.4.324