Importance of perinatal mental health

Importance of perinatal mental health

Pregnancy, birth and the first two years of a child’s life (the perinatal period) are a key period for families (3) and a critical time for the social, physical, emotional and language development of infants (4). Mental health conditions that occur during this time can have a particularly strong negative impact. Whether and to what extent there is a negative impact depends on a range of factors, including quality of parenting and the length and severity of the mental health condition (5).

Figure 2: Impacts of undiagnosed or untreated perinatal mental health conditions

Impact of perinatal mental health conditions on individuals

  • Perinatal mental health conditions can be strong predictors of long-term mental health: one study of a mother and baby unit found that, 3.5 years after childbirth, 40% of mothers who had perinatal mental health conditions continued to have depression (6).
  • Suicide is a leading cause of maternal deaths, accounting for 30% of maternal deaths in 2018 – 20 (7).

Impact of perinatal mental health conditions on infants

  • The first 1,001 days of life are critical for brain development
  • Perinatal mental healthcare may be a key opportunity to break the cycle of intergenerational trauma and adverse childhood experiences (ACEs) (2).
  • Although these risks are not inevitable, in some cases mental illness affects parents’ ability to bond with and care for their baby (8) and can predict child outcomes (9). For example:
    • Experiencing mental health conditions during pregnancy is associated with an increased risk of early delivery and low birth weight (10).
    • Maternal and paternal postnatal depression is associated with an increased risk of emotional and behavioural problems in children (9).
    • Chronic perinatal depression can impact child cognitive, emotional, social, behavioural and physical development (11).
  • Perinatal mental health conditions are more likely to impact child development when combined with social adversity and lack of social support (9).

Impact of perinatal mental health conditions on families

  • There is a correlation between paternal depression and maternal depression during the perinatal period (12).
  • Either parent experiencing a mental health condition during the perinatal period is associated with an increased risk of interparental conflict, relationship breakdown and domestic violence (9,13).

Impact of perinatal mental health conditions on society

  • Inadequate identification and treatment of perinatal depression, anxiety and psychosis has been estimated to cost society of £8.1 billion each year, the majority of which is due to long-term impacts on child outcomes (1).
  • Children growing up in more deprived areas are more likely to show externalising behaviour problems at age 5. Around 40% of this can be explained by maternal perinatal mental health, suggesting that targeting perinatal mental health may help reduce inequalities (14).

Additional resources 

References

  1. Department of Health & Social Care. Best start for life: A Vision for the 1,001 Critical Days [Internet]. 2021 [cited 2023 Feb 21]. Available from: https://www.gov.uk/government/publications/the-best-start-for-life-a-vision-for-the-1001-critical-days
  2. Cumberlege J. Better Births – Improving outcomes of maternity services in England. The National Maternity Review. 2016;
  3. Howard LM, Piot P, Stein A. No health without perinatal mental health. Vol. 384, The Lancet. 2014.
  4. Vliegen N, Casalin S, Luyten P, Docx R, Lenaerts M, Tang E, et al. Hospitalization-based treatment for postpartum depressed mothers and their babies: Rationale, principles, and preliminary follow-up data. Psychiatry (New York). 2013;76(2).
  5. Knight M, Bunch K, Patel R, Shakespeare J, Kotnis R, Kenyon S, et al. Saving Lives, Improving Mothers’ Care Maternal, Newborn and Infant Clinical Outcome Review Programme [Internet]. 2018 [cited 2023 Mar 14]. Available from: https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2022/MBRRACE-UK_Maternal_MAIN_Report_2022_v10.pdf
  6. O’Higgins M, Roberts ISJ, Glover V, Taylor A. Mother-child bonding at 1 year; Associations with symptoms of postnatal depression and bonding in the first few weeks. Arch Womens Ment Health. 2013;16(5).
  7. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, et al. Effects of perinatal mental disorders on the fetus and child. Vol. 384, The Lancet. 2014.
  8. Hogg S. Prevention in mind: All Babies Count: Spotlight on Perinatal Mental Health. NSPCC. 2013.
  9. Sutter-Dallay AL, Murray L, Dequae-Merchadou L, Glatigny-Dallay E, Bourgeois ML, Verdoux H. A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development. European Psychiatry. 2011;26(8).
  10. Paulson JF, Bazemore SD. Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. Vol. 303, JAMA. 2010.
  11. Ramchandani PG, Psychogiou L, Vlachos H, Iles J, Sethna V, Netsi E, et al. Paternal depression: An examination of its links with father, child and family functioning in the postnatal period. Depress Anxiety. 2011;28(6).
  12. Rutherford C, Sharp H, Hill J, Pickles A, Taylor-Robinson D. How does perinatal maternal mental health explain early social inequalities in child behavioural and emotional problems? Findings from the Wirral Child Health and Development Study. PLoS One. 2019;14(5).
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