Maternal mental health and reproductive outcomes: a scoping review of the current literature

Arch Gynecol Obstet. 2020 Oct;302(4):801-819. doi: 10.1007/s00404-020-05685-1. Epub 2020 Jul 15.

Abstract

Purpose: Current data show that maternal mental conditions affect about 10% of pregnant women worldwide. Assessing timing and patterns of mental health illness, therefore, is critical to ensure the wellbeing of the mother, the new-born and the whole family. The aim of this review is to summarize the latest evidence linking maternal mental disorders and adverse reproductive outcomes.

Methods: Following the PRISMA guidelines for systematic reviews, a literature search was conducted to ascertain the possible impact of mental health conditions on reproductive outcomes before and during pregnancy. The comprehensive strategy included cohort studies, randomised controlled trials and literature reviews on women with Primary Maternal Mental Illness (PMMI) and Secondary Maternal Mental Illness (SMMI) considering periconceptional, obstetric and foetal-neonatal outcomes. PubMed, WoS, CINAHL and Google scholar were used for the search. Cross-referencing in bibliographies of the selected papers ensured wider study capture.

Results: Evidence linking depressive disorders and infertility among PMMI is weak. Given this, women with prior mental conditions experience additional distress when undergoing fertility treatments. Primary mental disorders may also increase the risk of miscarriage and other pregnancy complications (e.g., gestational diabetes). For SMMI, there is more robust evidence correlating Preterm Birth (PTB) and Low Birth Weight (LBW) with common mental disorders which develop during pregnancy.

Conclusion: Prevention and management of maternal mental health diseases and minor mental conditions within the first 1000 days' timeframe, should have a place in the holistic approach to women going through reproductive decisions, infertility treatment and pregnancy.

Keywords: Maternal mental health; Maternal-foetal; Neonatal health; Reproductive outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Female
  • Humans
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Maternal Health
  • Mental Disorders / drug therapy*
  • Mental Disorders / psychology
  • Mental Health / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Pregnancy Outcome*
  • Pregnant People / psychology*
  • Premature Birth / prevention & control
  • Prenatal Care

Substances

  • Antidepressive Agents