Prenatal and perinatal risk factors for anxiety disorders among children and adolescents: A systematic review

Ståhlberg, Tiia; Khanal, Prakash; Chudal, Roshan; Luntamo, Terhi; Kronström, Kim; Sourander, André

doi:10.1016/j.jad.2020.08.004

Cited by 14 publications

(12 citation statements)

References 96 publications

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“…Chronic disease multimorbidity was defined as one individual having records of two or more non-communicable chronic diseases (psychiatric or somatic) during the same or subsequent secondary care episode(s). The diseases constituting multimorbidity were selected based on evidence on commonly occurring diseases among preterm and term born adolescents and young adults [21,24,25,[36][37][38][39][40][41][42][43][44]. Multimorbidity was identified using data on both in-patient and out-patient hospital care (referred to in the Nordic context as specialised healthcare), based on diagnostic codes listed in S1…”

Section: Chronic Disease Multimorbiditymentioning

confidence: 99%

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

et al. 2021

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Background People who were born prematurely have high risks of many individual diseases and conditions in the early part of the life course. However, our knowledge of the burden of multiple diseases (multimorbidity) among prematurely born individuals is limited. We aimed to investigate the risk and patterns of chronic disease multimorbidity in adolescence and early adulthood among individuals born across the spectrum of gestational ages, comparing preterm and full-term born individuals. Methods and findings We used individual-level data from linked nationwide registers to examine the associations of gestational age at birth with specialised healthcare records of ≥2 chronic diseases (multimorbidity) in adolescence (age 10–17 years) and early adulthood (age 18–30 years). Our study population comprised 951,116 individuals (50.2% females) born alive in Finland between 1st January 1987 and 31st December 2006, inclusive. All individuals were followed from age 10 years to the onset of multimorbidity, emigration, death, or 31 December 2016 (up to age 30 years). We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for multimorbidity using flexible parametric survival models. During 6,417,903 person-years at risk (median follow-up: 7.9 years), 11,919 individuals (1.3%) had multimorbidity in adolescence (18.6 per 10,000 person-years). During 3,967,419 person-years at risk (median follow-up: 6.2 years), 15,664 individuals (1.7%) had multimorbidity in early adulthood (39.5 per 10,000 person-years). Adjusted HRs for adolescent multimorbidity, comparing preterm to full-term born individuals, were 1.29 (95% CI: 1.22 to 1.36) and 1.26 (95% CI: 1.18 to 1.35) in females and males, respectively. The associations of preterm birth with early adult multimorbidity were less marked, with the adjusted HRs indicating 1.18-fold risk in females (95% CI: 1.12 to 1.24) and 1.10-fold risk in males (95% CI: 1.04 to 1.17). We observed a consistent dose-response relationship between earlier gestational age at birth and increasing risks of both multimorbidity outcomes. Compared to full-term born males, those born at 37–38 weeks (early term) had a 1.06-fold risk of multimorbidity in adolescence (95% CI: 0.98 to 1.14) and this risk increased in a graded manner up to 6.85-fold (95% CI: 5.39 to 8.71) in those born at 23–27 weeks (extremely premature), independently of covariates. Among females, the same risks ranged from 1.16-fold (95% CI: 1.09 to 1.23) among those born at 37–38 weeks to 5.65-fold (95% CI: 4.45 to 7.18) among those born at 23–27 weeks. The corresponding risks of early adult multimorbidity were similar in direction but less marked in magnitude, with little difference in risks between males and females born at 36–37 weeks but up to 3-fold risks observed among those born at 23–27 weeks. Conclusions Our findings indicate that an earlier gestational age at birth is associated with increased risks of chronic disease multimorbidity in the early part of the life course. There are currently no clinical guidelines for follow-up of prematurely born individuals beyond childhood, but these observations suggest that information on gestational age would be a useful characteristic to include in a medical history when assessing the risk of multiple chronic diseases in adolescent and young adult patients.

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Section: Chronic Disease Multimorbiditymentioning

confidence: 99%

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

et al. 2021

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“…The study did not find an association between maternal diabetes and anxiety disorders in offspring, which is consistent with the previous systematic reviews (Stahlberg et al ., 2020 ). Noticeably, however, that one of the included studies showed that the association became statistically significant when maternal diabetes combined with severe obesity, and was stronger than that of either alone (Kong et al ., 2020 ).…”

Section: Discussionmentioning

confidence: 99%

The risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases: a systematic review and meta-analysis

Gong

Fan

et al. 2022

Epidemiol Psychiatr Sci

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Aims The importance of prenatal maternal somatic diseases for offspring mood and anxiety disorders may be overlooked or undervalued. We conducted the first systematic review and meta-analysis assessing the risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases. Methods We screened articles indexed in Embase (including Embase, MEDLINE, PubMed-not-MEDLINE), PsycARTICLES and PsycINFO databases up to August 2021. 21 studies were included. We examined the overall associations between prenatal maternal somatic diseases and offspring mood/anxiety disorders. Analyses were stratified according to maternal somatic diseases and follow-up duration. Results We observed an increased risk of mood and anxiety disorders in the context of prenatal maternal somatic diseases [relative risk (RR) = 1.26; 95% confidence interval (CI) 1.15–1.37, RR = 1.31; 95% CI 1.24–1.38]; maternal obesity(RR = 1.92; 95% CI 1.72–2.11), hypertensive disorders (RR = 1.49; 95% CI 1.11–1.86) and infertility (RR = 1.26, 95% CI 1.14–1.39) were risk factors for mood disorders; maternal polycystic ovary syndrome (RR = 1.61; 95% CI 1.42–1.80), severe obesity (RR = 1.56; 95% CI 1.44–1.68) and moderate obesity (RR = 1.36; 95% CI 1.28–1.44) were risk factors for anxiety disorders. Prenatal maternal somatic diseases increased the risk of mood disorders in childhood and adulthood (RR = 1.71; 95% CI 1.34–2.09/RR = 1.19; 95% CI 1.09–1.30), as well as the risk of anxiety disorders in adulthood (RR = 1.33; 95% CI 1.26–1.41). Conclusion The results indicate that prenatal maternal somatic diseases are associated with offspring mood and anxiety disorders, and that the associations may be long-lasting.

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“…Birthing populations who experience maternal psychological distress, like pregnancy-related anxiety or mood disorders, have an elevated risk of PTB (41). Similar to other population-based cohort studies, we observed SMI (includes the diagnosis of a bipolar disorder) and depressive disorders were associated with excess risk for PTB (42).…”

Section: Discussionmentioning

confidence: 99%

“…Similar to other population-based cohort studies, we observed SMI (includes the diagnosis of a bipolar disorder) and depressive disorders were associated with excess risk for PTB (42). Some research has shown that PTB coupled with other maternal somatization disorders may result in a higher risk for mood and anxiety disorders for postpartum women (43) and children (41). One mechanism linking maternal distress with adverse infant health outcomes is parental confidence.…”

Section: Discussionmentioning

confidence: 99%

Association between perinatal mental health and reproductive and neonatal complications: a retrospective birth cohort study

Runkle

Risley

Roy

et al. 2022

Preprint

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Background: Maternal mental health as an important precursor to reproductive and neonatal complications remains understudied in the US, particularly in the Southeastern region, despite high medical costs and maternal morbidity, and infant burden. Objective: This study sought to estimate the incidence of perinatal mental health disorders and the associated increased risk of leading pregnancy and infant complications. Methods: A population-based retrospective birth cohort of delivery hospitalizations and readmissions was constructed for birthing populations in South Carolina, 1999 to 2017. Prevalence rates were calculated for perinatal mood and anxiety disorders (PMAD), severe mental illness (SMI), and maternal mental disorders of pregnancy (MDP). Poisson regression models using generalized estimating equations were used to estimate adjusted relative risks for the association between mental health conditions and severe maternal morbidity (SMM), hypertensive disorders of pregnancy (HDP), gestational diabetes (GD), cesarean delivery (CD), preterm birth (PTB), and low-birth weight (LBW). Results: The most prevalent maternal mental condition was MDP (3.9%), followed by PMAD (2.7%) and SMI (0.13%). PMAD was associated with a higher risk of SMM, HDP, and CD, as well as a higher risk of PTB and LBW infants. SMI was associated with LBW, HDP, and CD. Pregnant populations with MDP were more at risk for SMM, PTB, HDP, LBW, and CD. Each maternal mental health outcome was associated with an elevated risk for hospital readmissions up to 45 days after delivery. Discussion: Results demonstrated the escalating burden of PMAD and MDP for pregnant populations over time with important consequences related to maternal and infant morbidity.

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Prenatal and perinatal risk factors for anxiety disorders among children and adolescents: A systematic review

Cited by 14 publications

References 96 publications

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

Preterm birth and the risk of chronic disease multimorbidity in adolescence and early adulthood: A population-based cohort study

The risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases: a systematic review and meta-analysis

Association between perinatal mental health and reproductive and neonatal complications: a retrospective birth cohort study

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