Association between Prenatal and Postnatal Psychological Distress and Toddler Cognitive Development: A Systematic Review

Dawn Kingston, Sheila McDonald, Marie-Paule Austin, Suzanne Tough, Dawn Kingston, Sheila McDonald, Marie-Paule Austin, Suzanne Tough

Abstract

Purpose: Maternal psychological distress is one of the most common perinatal complications, affecting up to 25% of pregnant and postpartum women. Research exploring the association between prenatal and postnatal distress and toddler cognitive development has not been systematically compiled. The objective of this systematic review was to determine the association between prenatal and postnatal psychological distress and toddler cognitive development.

Methods: Articles were included if: a) they were observational studies published in English; b) the exposure was prenatal or postnatal psychological distress; c) cognitive development was assessed from 13 to 36 months; d) the sample was recruited in developed countries; and e) exposed and unexposed women were included. A university-based librarian conducted a search of electronic databases (Embase, CINAHL, Eric, PsycInfo, Medline) (January, 1990-March, 2014). We searched gray literature, reference lists, and relevant journals. Two reviewers independently evaluated titles/abstracts for inclusion, and quality using the Scottish Intercollegiate Guideline Network appraisal tool for observational studies. One reviewer extracted data using a standardized form.

Results: Thirteen of 2448 studies were included. There is evidence of an association between prenatal and postnatal distress and cognitive development. While variable effect sizes were reported for postnatal associations, most studies reported medium effect sizes for the association between prenatal psychological distress and cognitive development. Too few studies were available to determine the influence of the timing of prenatal exposure on cognitive outcomes.

Conclusion: Findings support the need for early identification and treatment of perinatal mental health problems as a potential strategy for optimizing toddler cognitive development.

Conflict of interest statement

Competing Interests: The authors would like to thank the Alberta Centre for Child, Family, and Community Research for their financial support of this project. Dr. Kingston is grateful for support provided through an Early Career Transition Award from the Alberta Centre for Child, Family and Community Research and a New Investigator Award through the Canadian Institutes of Health Research. Dr. Tough is supported by Alberta Innovates – Health solutions. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Flow Diagram.
Fig 1. Flow Diagram.

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Source: PubMed

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