The importance of looking after the mental health of parents during pregnancy and after childbirth, in order to promote the physical and mental wellbeing of both parents and child, is highlighted by researchers in a new series of articles in The Lancet.
The articles were edited by Professor Alan Stein of Oxford University and Louise Howard of King's College London, and discuss the range of mental health disorders that can occur during pregnancy and after childbirth. The papers cover how often they occur; their causes; the risks to mother and baby; treatments that are effective; and how we can prevent these disorders. The authors also draw attention to gaps in our knowledge and where more research is urgently required.
Professor Howard says: 'For many parents, the arrival of a child is a challenging time. The stigma around ante and postnatal mental illnesses can prevent people from getting the help they need. It’s important that people seek treatment promptly to prevent suffering and distress for the whole family. We want the public to know that there are effective treatments out there.'
Mental health disorders are common during pregnancy and the postnatal period (together known as the 'perinatal' period) – occurring in more than 10% of women in high income countries. In low and middle income countries the rates are probably even higher.
A recent report revealed the UK long-term economic costs of perinatal mental disorders to society to be £8 billion a year. The burden of perinatal mental health disorders may be even greater in low and middle income countries because the loss of earning from an inability to work has a greater impact on the families’ health and nutrition. Where resources are scarce, children are more at risk of being affected by perinatal mental health disorders and innovative strategies are needed to help tackle this problem.
The first paper summarises the risk factors for common mental health disorders during the perinatal period, such as anxiety, depression, eating disorders and post-traumatic stress disorder (PTSD). Most research has focused on postnatal depression and more research is needed to fully understand the other disorders, say the authors.
The care of illnesses, such as bipolar disorder and schizophrenia, during the perinatal period is discussed in the second paper in the series.
The third paper in the series summarises the evidence for links between parental mental health disorders and the risk of low birthweight, prematurity, and later psychological disturbances in children.
The ways in which particular perinatal mental health disorders are associated with specific aspects of child development are complex and not yet fully understood, say the authors. They add that most research has focussed on disorders in mothers, but depression in fathers is more common than previously thought with emerging evidence suggesting that this is also associated with effects on children.
'Adverse effects of perinatal mental health disorders on children are not inevitable and many children are not adversely affected. Early identification and intervention are critical in preventing them,' says Professor Stein, Head of Child and Adolescent Psychiatry at the University of Oxford.
'We need to treat both the parent’s symptoms and help with caregiving difficulties. Parents at risk of mental health disorders during or after pregnancy need to be identified early to try to prevent symptoms from affecting offspring.'
Source: King’s College London