Prenatal maternal mental health and fetal growth restriction: a systematic review

Abstract

Maternal mental disorders during pregnancy are associated with a range of adverse health outcomes for offspring. This systematic review examines studies reporting on the relationship between maternal depression, anxiety or stress during pregnancy and fetal growth measured during pregnancy using ultrasound biometry. A systematic search of PsycINFO, Medline, Scopus, Web of Science and Embase was conducted and 1575 records were identified, with nine studies meeting inclusion criteria gathering data from over 7000 participants. All studies measured depression, six examined anxiety and depression, and five examined all three exposures. The majority measured symptoms rather than clinically diagnosable disorder. Studies consistently reported significant associations between maternal mental health, particularly anxiety symptoms, and reduced fetal head growth. Other fetal growth parameters showed inconsistent findings. A number of studies suggest that cortisol dysregulation associated with maternal mental health may play a role in fetal growth restriction. However, heterogeneity in the timing of growth measurement, assessment measures used for mental health and inconsistencies in adjustment for confounders, limits the synthesis and interpretation of findings. Future studies should consider differences in the timing, intensity and duration of mental health symptoms over pregnancy and should employ diagnostic assessment of mental disorders. Fetal growth should be repeatedly measured and further work is needed to establish the biological mechanisms involved.

Sintomas depressivos na gestação e fatores associados: estudo longitudinal

“…The presence of these symptoms at high levels can lead to unfavorable maternal and perinatal outcomes. (2)(3)(4)(5) The least frequent was the thought about injuring oneself. However, its presence at all stages shows the importance of a specific screening tool to identify pregnant women at risk.…”

“…Depression may persist in the postpartum period and compromise parental behavior, the relationship with the partner and family, the process of mother-child bonding, and the child's cognitive, motor and psychosocial development. (2)(3)(4)(5) Studies on depression and its effects in the prenatal period are recent, dating back two decades, with an increase thereafter.…”

Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: a population-based study

“…Physical/sexual abuse may cause a range of health problems such as sexually transmitted infections, chronic pains, fractures as well as stress, anxiety and depression,9 and inability to be a good parent after childbirth 6. Furthermore, violence during pregnancy has been associated with fetal growth restriction, adverse pregnancy outcomes and childhood growth impairment 10 11. Depression and stress may subsequently lead to increased levels of stress hormones during pregnancy and reduced placental circulation 10.…”

Blood folic acid, vitamin B12, and homocysteine levels in pregnant women with fetal growth restriction

“…It is defined as having a weight at two standard deviations (tenth percentile) below that of a normal fetus, or at <2.5 kg after 37 weeks of pregnancy (Seravalli and Baschat, 2015). The cause for abnormal fetal size may be either extrinsic (placenta, matrix) or intrinsic to the fetus itself (Lewis et al, 2016;Xiao et al, 2016). Studies have shown that FGR is the second leading cause of deaths among fetuses during the perinatal period, with a threefold increase in mortality rates as compared to that of a normal neonate (Boulet et al, 2006).…”