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

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

doi:10.1371/journal.pone.0126929

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

PLoS One. 2015 May 21;10(5):e0126929. doi: 10.1371/journal.pone.0126929. eCollection 2015.

Authors

Dawn Kingston¹, Sheila McDonald², Marie-Paule Austin³, Suzanne Tough⁴

Affiliations

¹ Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
² Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ St. John of God Health Care, University of New South Wales, Burwood, Australia.
⁴ Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Centre for Child, Family and Community Research, Calgary, Alberta, Canada.

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.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Child Development*
Child, Preschool
Cognition*
Female
Humans
Infant
Male
Maternal Exposure*
Pregnancy
Prenatal Exposure Delayed Effects*
Public Health Surveillance*
Stress, Psychological*

Grants and funding

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. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.